Enhancing the impact of therapeutic interventions.

A therapeutic intervention has impact if it reaches the patient's mind and remains available for times of need. Impact is the overcoming of attention, neglect and forgetfulness. Therapists enhance impact by: (a) building up patients' positive attention; (b) creating unusual and discrepant events; (c) strengthening the therapeutic message or the way it is conveyed; (d) drawing out patients' readiness for commitment and hard work; (e) creating bridges between therapy and the problem situation; (f) protecting the therapeutic message from trivializing and levelling events. These principles are nonspecific and are here illustrated by examples from widely different therapeutic approaches. Impact is not a substitute for the inherent value of a therapeutic message, but its lack can doom even our greatest inspirations.