This work deals with the analysis of the theoretical and practical profiles of the strategic clinical model in psychotherapy, starting from the examination of the historical and evolutionary contents of this particular model, passing through the main theories and techniques used in the clinic.

Psychotherapy works. The results of numerous studies show that those individuals treated are better off than those not treated or on waitlists with an average effect size of .8 (Duncan et al., 2008). To put it in perspective, the effects of psychotherapy are equal to those found for coronary artery bypass surgery and 4 times greater than fluoride in the prevention dental cavities. Yet, three persistent problems plague the psychotherapy field: 1) clients drop out of therapy at alarming rates – almost half of clients decide not to continue and prematurely terminate; 2) not only do therapists not notice when clients are at risk for dropping out, they also do not detect when things are getting worse (approximately 10% of clients get worse after starting therapy); and 3) a small percentage of clients (10%) accounts for the largest amount of expenditures (Minami, 2008). This last finding may be the result of therapists not realizing when things are not working or getting worse and instead of changing course, doing more of what is not working, over and over again. Along these lines, most therapists do not have an accurate sense of their helpfulness and on average, overrate their effectiveness by 65% (Chow, 2014). Given the issues with retention, coupled with the self-assessment bias among therapists, it’s not surprising that psychotherapy outcomes have not appreciably improved over the past 40 years.

Accepting to face a path of psychotherapy is not in itself sufficient to achieve the goals set in the therapeutic agreement between patient and professional. The present work analyses the differences between "consciousness" (and knowledge) of ones dysfunctional state, "will" to achieve change and "awareness of change", passing through all the traps that the mind can set for us, starting from the alterations of the states of consciousness to the wrong perceptual processes (which rework the external sensory data collected by the sense organs) to the not necessarily dysfunctional use of defense mechanisms, the imperfect centering on the knowledge of once own needs and requirements, the excessive rigidity of once system of beliefs, certainties and mental constructs, the use of irrational ideas based on empirical data falsely considered correct, the subjection of social influences and conditionings to impressions and systematic errors determined by cognitive dissonances and social and moral disengagements. The present work then focuses on the goals that the therapist must achieve to help the patient in his or her process of awareness and acceptance of change, and on recent techniques focused on the patients emotional and emotional needs.

Purpose: Youth living in the urban slums in Uganda have many unmet needs. The purpose of the current study is to briefly examine the associations between Adverse Childhood Experiences (ACEs) and alcohol use patterns, an understudied area among urban vulnerable youth, in order to provide guidance and insight for service provision for youth. Methods: The current data analysis is based on a cross-sectional survey conducted in June 2011 which consisted of a convenience sample of youth living in the slums (ages 14-24) attending a drop-in center, Uganda Youth Development Link (UYDEL). Descriptive statistics were computed. Bivariate and multivariable logistic regression analyses were used to determine psychosocial correlates with being an orphan. Results: Factors associated with alcohol use varied by sex (p<.05) (alcohol use was more common among girls), age (p<.000), (alcohol use more common among youth 18 years of age and older) and alcohol use were also more common among youth who reported the following ACEs; parents hitting each other (p<.000) , parental use of alcohol (p<.000), being hungry (p<.000), having ever lived on the street (p<.000) and having been raped (p<.000). Conclusions: The prevalence of ACEs were high in this study population which is a great concern. Moreover ACEs were associated with earlier age of alcohol use initiation, frequent and heavy drinking underscoring the need for additional support for past childhood trauma as well as alcohol prevention efforts for these vulnerable youth.