Table Of ContentCommunicating with Vulnerable
Patients
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 behaviour 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.
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.
The Forensic Psychotherapy Monograph Series
Series Editor: Professor Brett Kahr
The Official Publication Series of the International Association for Forensic Psychotherapy
Selected titles in the series:
Violence: A Public Health Menace and a Public Health Approach
Edited by Sandra L. Bloom
Forensic Psychotherapy and Psychopathology: Winnicottian Perspectives
Edited by Brett Kahr
Dangerous Patients: A Psychodynamic Approach to Risk Assessment and Management
Edited by Ronald Doctor and Sarah Nettleton
The Mind of the Paedophile: Psychoanalytic Perspectives
Edited by Charles W. Socarides and Loretta R. Loeb
Violence in Children: Understanding and Helping Those Who Harm
Edited by Rosemary Campher
Murder: A Psychotherapeutic Investigation
Edited by Ronald Doctor
Psychic Assaults and Frightened Clinicians: Countertransference in Forensic Settings
Edited by John Gordon and Gabriel Kirtchuk
Forensic Aspects of Dissociative Identity Disorder
Edited by Adah Sachs and Graeme Galton
Playing with Dynamite: A Personal Approach to the Psychoanalytic Understanding of
Perversions, Violence, and Criminality
Estela Welldon
The Internal World of the Juvenile Sex Offender: Through a Glass Darkly then Face to
Face
Timothy Keogh
Disabling Perversions: Forensic Psychotherapy with People with Intellectual Disabilities
Alan Corbett
Sexual Abuse and the Sexual Offender: Common Man or Monster?
Barry Maletzky
Psychotherapy with Male Survivors of Sexual Abuse: The Invisible Men
Alan Corbett
Consulting to Chaos: An Approach to Patient-Centred Reflective Practice
Edited by John Gordon, Gabriel Kirtchuk, Maggie McAlister, and David Reiss
New Horizons in Forensic Psychotherapy: Exploring the Work of Estela V. Welldon
Edited by Brett Kahr
The End of the Sentence: Psychotherapy with Female Offenders
Edited by Pamela Windham Stewart and Jessica Collier
For further information about this series please visit www.routledge.com/The‑
Forensic‑Psychotherapy‑Monograph‑Series/book‑series/KARNFPM
The Forensic Psychotherapy Monograph Series
Communicating with
Vulnerable Patients
A Novel Psychological Approach
Maria Leticia
Castrechini Fernandes Franieck
With Contribution from Niko Bittner
Designed cover image: © Maria Leticia Castrechini Fernandes
Franieck
First published 2023
by Routledge
4 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
605 Third Avenue, New York, NY 10158
Routledge is an imprint of the Taylor & Francis Group, an informa
business
© 2023 Maria Leticia Castrechini Fernandes Franieck
The right of Maria Leticia Castrechini Fernandes Franieck to be
identified as author of this work has been asserted in accordance
with sections 77 and 78 of the Copyright, Designs and Patents
Act 1988.
All rights reserved. No part of this book may be reprinted
or reproduced or utilised in any form or by any electronic,
mechanical, or other means, now known or hereafter invented,
including photocopying and recording, or in any information
storage or retrieval system, without permission in writing from
the publishers.
Trademark notice: Product or corporate names may be trademarks
or registered trademarks, and are used only for identification and
explanation without intent to infringe.
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British
Library
ISBN: 978-1-032-14041-4 (hbk)
ISBN: 978-1-032-14042-1 (pbk)
ISBN: 978-1-003-23208-7 (ebk)
DOI: 10.4324/9781003232087
Typeset in Times New Roman
by Apex CoVantage, LLC
To my twin sons Erick Franieck and Lucas Franieck, for
making my life brighter
and
to my colleague Niko Bittner, for his valuable
companionship
Contents
List of Contributors ix
Series Editor’s Foreword x
BRETT KAHR
Preface xv
Acknowledgements xvii
Introduction xviii
PART ONE
On building communication 1
1 Handling, mastering, and integrating a personal and
factual reality 3
2 On intercultural interactional communication 8
3 TICA – Transient Interactive Communication Approach 24
PART TWO
TICA in forensic settings 37
4 TICA in withdrawal therapy 39
5 TICA in pretrial detention 87
PART THREE
TICA in intercultural settings 113
6 TICA in short‑term therapy with traumatized refugees 115
7 TICA in multicultural team supervision 138
viii Contents
PART FOUR
TICA adaptations (variations) 153
8 T‑WAS – Together We Are Strong 155
WITH CONTRIBUTION FROM NIKO BITTNER
9 TICA in the COVID‑19 pandemic 186
WITH CONTRIBUTION FROM NIKO BITTNER
PART FIVE
Reflections on TICA 203
10 Outcomes and limitations 205
Index 234
Contributor
Niko Bittner is a qualified pedagogue and Gestalt therapist. He works in youth
social work and is a seminar leader at the Odenwald Institute, Germany, where
he trains conflict coaches, among other things.
