Contextual-Conceptual Therapy (CCT) is the creation of Fredric Matteson.

He has distilled this innovative therapeutic model through the lens of his dual skills as a poet and as a psychotherapist. His college work included a degree in Expressive Arts as well as post-graduate work in an MFA program in writing. An award-winning poet, he brings metaphor into the work of healing suicidal persons, with great success. Early work in the mental health field included work in psychiatric institutions in California as well as in the mental health units of public hospitals in Washington State. In his 27 years in the mental health field he has seen over 16,000 suicidal inpatients in individual and group therapy. Along with his ongoing clinical work, his work now also includes private practice, program development, trainings for organizations, consultations, as well as presentations before national and international conferences.

The CCT program is broken into 4 sections:

1. 1.Facing (Contextual)
   

2. 2.Seeing (Conceptual)
   

3. 3.Thinking (Cognitive)
   

4. 4.Doing (Behavioral) 
   

There are 36 "assignments" (9 assignments per section) to choose from -- to tailor to each suicidal client's individual needs.

Abstract 

Traditional medical/psychiatric models approach the problem of suicidality from a variety of theoretical perspectives: biological, cognitive, psychodynamic, etc. However, practical interventions based on these theories often fail. Many suicidal persons often admit to years of counseling, hospitalizations, and medication. They say they will feel better for awhile but then feel twice as suicidal the next time they are in crisis. What this indicates is that an underlying problem keeps changing form, but never changes.

    I have sought to understand the core experience of being suicidal by exploring the language of suicidal persons in the midst of suicidal crises. Through therapeutic processes with over 16,000 inpatients, I find that suicidal persons universally communicate about an existence in a bifurcated state where who they are to us is not who they are to themselves. The suicidal person is trapped in unknowingly finding ways to sustain both “selves” and this unreal, painful, disconnected state leads to a lethal spiral downwards—in such a bifurcated state, a place of solace cannot be sustained. As therapists, we unknowingly participate in this bifurcation by comforting or “stabilizing” them. They are thereby validated for a state, a self that is really not stable inside of them.

    Reasoning, traditional cognitive-behavioral approaches and even medications may help for awhile but cannot really reach them. An indirect form of communication is needed to bypass the fierce intelligence and resistance which sustains this psychological and emotional trap. By utilizing metaphor and experiential methods, I have found ways to offer suicidal persons a stereoscopic perspective using metaphoric resonance to bypass the entrenched internal illogic that binds them.

    I have integrated my learning and methods into a model of therapy derived from the patients’ own voices. Called Contextual-Conceptual Therapy: Guiding Suicidal Person, Using Maps, Models, & Metaphors, it has 4 stages and 32 complementary "assignments" available to tailor to the specific needs of each individual and their internal process and offer them a new pathway out of suicide, an intrinsic form of suicide prevention. This is designed to be adjunctive to traditional treatments and not replace them.

CCT Key Points

Population:

1. Psychiatric inpatients with severe suicidality, many with repeated episodes.
   

Findings (from Discourse with Over 16,000 Suicidal Individuals):

1. 1.Current therapies and medications are necessary but not sufficient. The underlying problem, though changing form, never changes.
   

2. 2.Comforting them in their state of self-deception can be dangerous. Suicidal persons are in an unreal, disconnected state very vulnerable to downward spirals.
   

3. 3.The suicidal persons are trapped in metaphorical thinking taking things literally. This leads to a bifurcated state (see abstract and brief paper) in which who they are to us is not who they are to themselves.
   

4. 4.The suicidal person cannot see where their pain is coming from and therefore cannot stop it.
   

5. 5.The suicidal persons’ “best” thinking makes them suicidal. Logic cannot break through the tenacious hold of their pain.
   

 

Treatment Principles:

1. 1.The treatment is adjunctive to, not instead of traditional treatment.
   

2. 2.The suicidal person needs to be in a safe, highly empathic context.
   

3. 3.The suicidal person needs to be destabilized, not stabilized. They must hold the pain that leads to suicide before them and within them, within their attention.
   

4. 4.They need to be guided to an experience of empathy for themselves while in this state.
   

5. 5.Metaphor and stories allows them to see and experience the root cause of their pain and help orient them contextually and conceptually.
   

 

Experience:

1. 1.Very high patient satisfaction, accolades and referrals by patients of other patients. They report a unique experience of solace and understanding.
   

2. 2.Applied in an inpatient setting serving patients in managed care and traditional medical model communities, the therapy has been well accepted over 10 years.
   

*All information, documents, products, graphics and other works (the “Materials”) provided on this Web site, including the look and feel of this Web site, are the copyrighted work of Fredric Matteson . Except as stated herein, none of the Materials may be copied, reproduced, distributed, republished, downloaded, posted or transmitted in any form or by any means, including, but not limited to, electronic, mechanical, photocopying, recording, or otherwise, without the prior express written permission of Fredric Matteson. You also may not, without Fredric Matteson’s prior express written permission, “mirror” or “frame” any portion of the Web site on any other server.

**Intellectual property

The names, images and logos identifying CCT and/or Contextual - Conceptual Therapy are the proprietary marks of Fredric Matteson. Copying our logos (the “Materials”) and any other third party logos accessed via this website is not permitted without the prior approval of the relevant copyright owner.