Countertranferance Among Play Therapists: Implications for Therapist Development and Supervision.

This study examined countertransference management among play therapists. Registered Play Therapist Supervisors (N=154) completed the Countertransference Factors Inventory-Revised and a demographic survey regarding a recent supervisee. The areas explored included countertransference management with regard to therapist gender, academic degree, license, theoretical orientation, type of supervision, population served, practice setting, play therapy training, and experience. A moderate positive correlation of 53% was found between play therapy training and countertransference management. A low positive correlation of 27% was found between years of experience and countertransference management. Differences were found among groups in the areas of degree, license, and practice setting. No significant findings were obtained for gender, theoretical orientation, population served, and type of supervision. The study provides recommendations and implications for supervision of developing play therapists, and suggestions for future research in the area of countertransference among play therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recognizing Defenses in the Drawings and Play of Children in Therapy.

Children's drawings and play have long been recognized as rich repositories of symbolic material derivative of infantile sexual fantasy. That view is based predominantly on the early drive theory approach to the interpretation of dreams with an almost exclusive focus on symbolic content. In an effort to broaden the interpretive skills available to the child therapist, this article places the content of children's drawings and play into the background and brings the defensive processes into higher relief. It addresses the defenses in children's play and even more so the defenses in children's drawings. Without creating a simplistic formula, the author offers examples of ways to recognize defenses in children's drawings and play based on observations from clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Effects of Therapist and Patient Mood on the Therapeutic Functioning of High- and Low-Facilitative Therapists": Erratum.

Reports an error in the original article by Alan S. Gurman (Journal of Consulting and Clinical Psychology, 1973[Feb], 40[1], 48-58). On page 49, paragraph 2, line 8 should read "those preceded by negative therapist moods." (The following abstract of this article originally appeared in record 1973-21486-001.) Determined the effects of presession moods of 12 therapists and their patients on level of therapist empathy, warmth, and genuineness. Results of an intensively designed study indicate that high- and low-facilitative therapists were differentially affected by therapist moods. High-facilitative therapists functioned more facilitatively under dysphoric moods than under positive, while the opposite was true of low-facilitative. There were no differences in tape-rated therapist facilitativeness under different patient moods for either group, yet patients of low-facilitative therapists did perceive such a difference. It is concluded that the therapist feelings preceding the facilitative therapy hour were not the same for high- and low-facilitative therapists. The use of the intensive design in psychotherapy process research is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child-Centered Play Therapy with Children who are Homeless: Perspective and Procedures.

Children who are homeless are one of the fastest growing populations. However, the literature on play therapy with children who are homeless is sparse. This article provides play therapists with needed perspective of prevalence, causes, and mental health impact of homelessness. A Child-Centered Play Therapy approach, which emphasizes a safe relationship based on the core conditions, is recommended. Procedures to meet the needs of children who are homeless and to enlarge the meaning of their unique play themes, such as eviction and "I'm rich," are discussed. Play therapists are encouraged to fulfill their social responsibility by providing play therapy for children who are homeless. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Play therapists' self-perceived multicultural competence and adequacy of training.

Explored the self-perceived multicultural competencies and adequacy of multicultural training of play therapists across the United States. Registered play therapists belonging to the Association for Play Therapy (N=134) completed the Multicultural Counseling Survey (MMCTS) (C. C. Holcomb-McCoy & J. E. Myers, 1999). Results indicate that play therapists perceive themselves as competent on Multicultural counseling competence. The results also suggest that play therapists perceived their multicultural training as less than adequate. Although results indicate no difference between play therapists' competence and training based on years of experience, there was a difference in multicultural competence and training based on coursework in multicultural counseling. Implications for practice and future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The development of the client-therapist bond through the lens of attachment theory.

The bond between client and therapist, a component of the global alliance, is widely believed to play a crucial role in supporting the work of therapy. However, we know little about how the client-therapist bond becomes established and have few theoretical tools to conceptualize its development. Attachment theory, with its focus on the development and dynamics of intimate relationships, is a lens through which we can expand our understanding of the client-therapist bond. I argue that the therapeutic bond may be usefully viewed as an in-progress attachment to therapists. Using Bowlby (1969/1982) and Ainsworth's (Ainsworth et al., 1978) ideas about normative attachment development, I present a phase model of attachment to the therapist and include behavioral, cognitive, emotional, and physiological markers of each phase. I draw empirical support from the psychotherapy process and alliance literatures and discuss research considerations and clinical implications of the model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How Does Motivational Interviewing Work? Therapist Interpersonal Skill Predicts Client Involvement Within Motivational Interviewing Sessions.

Although many studies have shown that motivational interviewing (MI) is effective in reducing problem behaviors, few have investigated purported causal mechanisms. Therapist interpersonal skills have been proposed as an influence on client involvement during MI sessions and as a necessary precursor to client commitment language. Using the Motivational Interviewing Skills Code (MISC; Version 1.0) rating system, the authors investigated 103 unique MI sessions for substance abuse and found that therapist interpersonal skills were positively associated with client involvement as defined by cooperation, disclosure and expression of affect. An unexpected finding indicated that behaviors inconsistent with MI enhanced the impact of therapist interpersonal skills upon client involvement. Drawbacks to the study include a potential sampling bias and uneven reliability of the variables measured. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Erratum to Matthews and Burkhart.

Reports an error in the article "A-B Therapist Status, Patient Diagnosis, and Psychotherapy Outcome in a Psychiatric Outpatient Population" by Jerry G. Matthews and Barry R. Burkhart (Journal of Consulting and Clinical Psychology, 1977, Vol. 45, No. 3, pp. 47S-482), the next to last sentence of the abstract is incorrect. The sentence reads: "Separate analyses of variance demonstrated further support for the super-A hypothesis with therapists' ratings as the dependent variable, whereas the interaction hypothesis received support, with number of sessions as the dependent measure." The sentence should read: "Separate analyses of variance demonstrated further support for the super-A hypothesis with number of sessions attended as the dependent measure, whereas the interaction hypothesis received support, with therapists' ratings as the dependent variable." (The following abstract originally appeared in record 1978-03783-001) Previous research generally has supported the hypothesis that A therapists obtain better therapy outcomes with schizophrenics, while B therapists do better with neurotics. Based on recent evidence, a 2nd hypothesis (super A) has been advanced which predicts that A therapists do at least as well with neurotic patients as do B therapists and that As obtain significantly more positive outcomes with schizophrenics. To examine these hypotheses, the therapy outcomes of 7 A and 4 B therapists, differentiated by their scores on the 23-item Whitehorn and Betz (1957) A-sub( scale, with their 18 schizophrenic and 18 neurotic patients were examined. A multivariate ANOVA computed for the 2 outcome measures, therapists' ratings of patient improvement and number of therapy sessions, clearly supported the super-A hypothesis. Separate ANOVAs demonstrated further support for the super-A hypothesis with therapists' ratings as the dependent variable, whereas the interaction hypothesis received support with number of sessions attended as the dependent measure. Of considerable importance was the fact that the addition of ataractic medication to the treatment of schizophrenics did not attenuate the effect of the A-sub( therapist distinction on therapeutic outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist Alliance-Building Behavior Within a Cognitive-Behavioral Treatment for Anxiety in Youth.

Explored the specific behavior of therapists contributing to a child client's perception of a therapeutic alliance with youth (n = 56) who received a manualized cognitive-behavioral treatment for anxiety disorders. The first 3 sessions were coded for 11 therapist behaviors hypothesized to predict ratings of alliance. Child, therapist, and observer alliance ratings were gathered after the 3rd and 7th therapy sessions. "Collaboration" positively predicted early child ratings of alliance, and "finding common ground" and "pushing the child to talk" negatively predicted early child ratings of alliance. Although no coded therapist behaviors predicted early therapist ratings of alliance, "collaboration" and "not being overly formal" positively predicted therapist alliance ratings by Session 7. Child, observer, and therapist ratings of alliance were significantly correlated. Results are discussed with regard to the identified behavior of the therapist as a step toward the identification of empirically supported strategies for building a stronger child-therapist alliance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Play therapy instruction: A model based on objectives developed by the Delphi technique.

The purpose of this study was to determine the core skills/methods and practicum experiences play therapy experts and professors believe to be essential in the education of the beginning play therapist in the specific areas of theory, history, terms, organizations, authors who have contributed to the field, methods, skills, training in special populations, practicum experience, and advanced skills. Using the Delphi technique, two questionnaires were used to obtain opinions from play therapy experts and play therapy instructors. The first scale was sent to twelve play therapy experts to obtain their opinions on the core curriculum and experiences necessary for training a play therapist in an introductory play therapy class, practicum experience, and advanced play therapy training. Frequencies and means were obtained and used to delete and add items for the revised scale. The revised scale was sent to 180 play therapy professors. Fifty play therapy professors returned the instrument. The professor's ratings were used to develop curriculum content for training play therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Play therapy and psychopharmacology: What the play therapist needs to know": Correction.

Reports an error in "Play therapy and psychopharmacology: What the play therapist needs to know" by Daniel S. Sweeney and Ross J. Tatum (International Journal of Play Therapy, 1995, Vol 4[2], 41-57). The table "Childhood DSM-IV Diagnoses and Psychotropic Medications That May Be Indicated" on pages 46-47 contained three (3) errors. A corrected copy of the table is included with the erratum. (The following abstract of the original article appeared in record 1997-05134-004.) Provides a basic overview of pediatric psychopharmacology and examines specific related considerations for the play therapist. The article also addresses some medication considerations specific to the treatment modality of play therapy. It is argued that possession of even a cursory knowledge about child psychopharmacology places the play therapist in a better position to provide quality treatment. A list of childhood Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnoses and psychotropic medications that may be indicated is provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist techniques, client involvement, and the therapeutic relationship: Inextricably intertwined in the therapy process.

[Correction Notice: An erratum for this article was reported in Vol 43(3) of Psychotherapy: Theory, Research, Practice, Training (see record 2006-12148-016). an author's name was incorrectly spelled in a reference. The correct reference is presented.] I propose that therapist techniques, client involvement, and the therapeutic relationship are inextricably intertwined and need to be considered together in any discussion of the therapy process. Furthermore, I present a pantheoretical model of how these three variables evolve over four stages of successful therapy: initial impression formation, beginning the therapy (involves the components of facilitating client exploration and developing case conceptualization and treatment strategies), the core work of therapy (involves the components of theory-relevant tasks and overcoming obstacles), and termination. Theoretical propositions as well as implications for training and research are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exploring the contribution of supervisors to intervention outcomes.

Supervision has been identified as perhaps the most important mechanism for developing competencies in therapists in training. However, there is scant research on the effect of supervisors on client outcome. Moreover, in a relatively recent review of the existing literature, significant methodological concerns were raised that attenuate the interpretability of the existing reported findings. The current study therefore sought to address such methodological concerns. Crosstabulation of supervisors by client outcome categories (i.e., recovered, reliably improved, no reliable change, deteriorated) indicated that supervisors are significantly related to client outcome, generating a moderate effect. Training programs are therefore encouraged to routinely track client outcomes as an objective indicator of quality supervision. Additional implications for training programs and suggestions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring the Real Relationship in Psychotherapy: Initial Validation of the Therapist Form.

The development and initial validation of a therapist-rated measure of the real relationship in psychotherapy (the Real Relationship Inventory--Therapist Form [RRI-T]) is reported. Using a sample (n=80) of practicing psychotherapists and on the basis of prior theory, the authors developed a 24-item measure consisting of 2 subscales (Realism and Genuineness) and a total score. This 24-item version and other measures used for validation were completed by 79 additional practicing therapists and 51 counseling graduate students (n=130). The RRI-T was found to have high reliability and sound initial validity. As theorized, the RRI-T correlated significantly with measures of working alliance, session outcome (depth and smoothness), client intellectual and emotional insight, and client negative transference. Discriminant validity was supported by a nonsignificant relation to social desirability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Critical Review of Play Therapy Assessments.

As part of the creative modalities, play therapy offers a therapeutic mode for diagnosis, assessment, and treatment interventions. The purpose of this paper is to critically review three play therapy interventions: The Developmental Play Assessment, the Marschak Interaction Method, and the Family Systems Test. A brief introduction to each assessment will be presented. Additionally, validity and reliability data will be addressed. The overall evaluation will include the assessments desirable as well as undesirable features, which is of critical importance to play therapists and those therapists using play as a method of diagnosis and assessment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multicultural Considerations in the Delivery of Play Therapy Services.

It is estimated that by the year 2025, the number of minority children will outnumber the number of majority children in the United States. Play therapists have an increasing need to be able to provide culturally sensitive services. This article discusses issues of culture, ethnic identity, and minority status and their relevance to the practice of play therapy. Play therapists can improve their cultural sensitivity through (a) expanding their knowledge of specific cultures of children they serve, (b) increasing their ability to understand the variety of cultural influences on a child and assessing the impact of the various influences, and (c) increasing their understanding of the ways children from minority cultures are taught to cope with minority status. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Influence of Therapist Adherence and Competence on Client Reprocessing of Child Abuse Memories.

This study follows previous research examining change processes in emotion-focused therapy for adult survivors of child abuse (N = 37). Therapist (n = 10) adherence to intervention principles and competence with an imaginal confrontation (IC) intervention were examined in the context of relationship skills. The Therapist Facilitating Scale assessed competence with IC. Therapists differed in technical (but not relationship) skills; relationship skills and IC competence (but not adherence) improved over therapy. Therapist competence predicted better client processes during IC. Relationship skills independently contributed to abuse resolution; the potency of IC (Competence x Frequency of Implementation) independently contributed to reduced interpersonal problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists at risk: The perils of the intimacy of the therapeutic relationship.

Review of book: Therapists at Risk: The Perils of the Intimacy of the Therapeutic Relationship by Lawrence E. Hedges, Robert Hilton, Virginia Wink Hilton, and O. Brandt Caudill, Jr., Northvale, NJ: Jason Aronson, 1997, 317 pp. Reviewed by Alma H. Bond. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Further data concerning the dimensionality of ratings of the therapist's verbal exploratory behavior.

An earlier experiment using repeated measures on the same Ss applied a semantic differential (SD) to 10 therapists' exploratory statements. It was shown that: (a) 3 orthogonal dimensions (Precision/Potency, Professional Evaluation, and Subjectivity-Objectivity) account for the ratings; (b) anxiety-Arousal is correlated only with the 1st factor. This study evaluates those findings by using 4 independent groups of Ss rating therapist's statements in 2 interviews along only 1 of the dimensions. Independence of the 3 dimensions is confirmed for 1 interview, but not quite so for the other. Anxiety-Arousal is under present conditions correlated with all 3 dimensions. Results derived from the SD model must therefore be treated with caution. (PsycINFO Database Record (c) 2010 APA, all rights reserved)