"Superblind": Supervising a Blind Therapist With a Blind Analysand in a Community Mental Health Setting.

This article describes the 3-year psychoanalytic treatment of a blind female client by a blind female therapist supervised by a sighted man. The author focuses primarily on issues tied to each party's personal experience of blindness. Interpersonal psychoanalysis, which was the modality of supervision and therapy, is considered a cultural approach to psychoanalytic treatment. The author (the supervisor in the triad) suggests that the individuals involved treated each other, and were treated, with regard to their shared visual problems in ways that were influenced by previous relationships and the way that the culture in which the members were embedded treats disability in general. In the present, these cultural and relational expectations, influenced by the past, were played out between patient and therapist, between therapist and supervisor, and in the decisions and policies of the clinic system. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment to the therapist.

This study examines the ways in which therapists function as attachment figures for patients. Patients in long-term psychoanalytic therapy answered questionnaires about their feelings about their therapists and their closest personal relationships. Components of attachment prominent in the therapeutic relationships were looking up to the therapist and feeling the therapist was responsive to emotional needs. Stronger attachment to therapists was associated with greater frequency and duration of therapy, a stronger working alliance, and greater security of the patients' attachment style, as well as with the gender of the patient and therapist. Using attachment theory to understand psychoanalytic relationships emphasizes the unique importance of a therapist to a patient and can offer new perspectives on both therapeutic and attachment processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parents' attitudes toward their child's therapist and therapy.

Parents of children in therapy typically have strong feelings and thoughts about their child's treatment, and their cooperation and support is often a critical aspect of successful treatment. Recent literature, in conjunction with the results of a small-scale study of 51 parents of children currently in treatment, suggests that contrary to classic psychoanalytic literature, parents experience primarily positive attitudes and feelings toward their child's therapist; they tend to feel hopeful, understood, and grateful. For the sake of both promoting and preserving therapeutic gains, therapists should actively pursue an alliance with parents and encourage their participation in their child's treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Across civilizations: Psychoanalytic therapy with Asians and Asian Americans.

This article addresses issues of psychoanalytic therapy with Asian North Americans both from their standpoint and the Euro-North American therapist. The latter are often unaware of deeply embedded cultural assumptions of individualism in their psyches and in psychoanalytic and psychological theories and norms. This can result in psychopathologizing Asian North Americans or seeing them as inferior. The most difficult part of doing psychoanalytic therapy with them is first learning a different normality/psychopathology continuum from Euro-North Americans, and then ascertaining where a patient's psychopathology is on this different continuum. The nature of the therapy relationship is related to three psychosocial dimensions of Asian hierarchical relationships. Anger, communication, the bicultural self, the magic-cosmic and spiritual self, and trauma and immigration are then delved into. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the basic ingredients of psychotherapy.

Presents a parsimonious statement of essential conditions for psychotherapeutic change: (a) a helping relationship patterned after the parent-child relationship, (b) the creation of a power base from which the therapist influences the client through common psychological techniques, and (c) a client who has the capacity to profit from the experience. It is asserted that the full range of common influencing techniques is inevitably brought to bear on any psychotherapeutic relationship, and this constitutes one of its defining characteristics. These conditions are equally applicable to psychoanalytic psychotherapy and behavior therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-disclosure.

A review of the analog literature about therapist self-disclosure suggests that nonclients generally have positive perceptions of therapist self-disclosures. A review of the naturalistic psychotherapy literature indicates that therapist self-disclosure occurs infrequently, is used more often by humanistic-experiential than psychoanalytic therapists, is most often about professional background than about intimate personal details, is used for many different reasons, is used cautiously by therapists, and is helpful in the immediate process of therapy. Effects of therapist self-disclosure on the ultimate outcome of therapy are less clear. Limitations of the research (poor and inconsistent definitions and lack of a clinically appropriate methodology for studying self-disclosure) and guidelines for therapeutic practice are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of four maintenance programs on the long-term management of obesity.

This study evaluated the effectiveness of four posttreatment programs designed to enhance the long-term maintenance of weight loss. Mildly and moderately obese adults (N?=?123) were randomly assigned to one of the following five conditions: (a) behavior therapy only; (b) behavior therapy plus a posttreatment therapist-contact maintenance program; (c) behavior therapy plus posttreatment therapist contact plus a social influence maintenance program; (d) behavior therapy plus posttreatment therapist contact plus an aerobic exercise maintenance program; or (e) behavior therapy plus posttreatment therapist contact plus both the aerobic exercise and social influence maintenance programs. All posttreatment programs were conducted in 26 biweekly sessions during the year following behavioral treatment for obesity. At an 18-month follow-up evaluation, all four conditions that combined behavior therapy with a posttreatment maintenance program yielded significantly greater long-term weight losses than behavior therapy alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effective ingredients in psychotherapy: Prediction of outcome from process variables.

Examined the impact of (a) exploration of the psychodynamic roots of patients' conflicts, (b) warmth and friendliness of the therapist-offered relationship, and (c) positiveness of patients' attitudes toward working in therapy on the outcome of brief therapy with 35 college males exhibiting symptoms of depression, anxiety, and social introversion. Symptoms were confirmed by elevated scores on the Depression, Psychasthenia, and Social Introversion scales, respectively, of the MMPI. Analyses of process ratings for audiotaped segments from 4 sessions throughout the course of therapy revealed that the activities of therapists of differing theoretical orientations and of professional vs untrained, "inherently helpful" therapists could be distinguished. Although patients' attitudes toward the therapist and patient involvement in the therapy process did not differ as a function of the type of therapist, the process dimension that most consistently predicted therapy outcome was patient involvement. Exploratory processes and therapist-offered relationship had a lesser influence on outcome. (71 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists' attributions for client premature termination: Are they self-serving?

We conducted two studies of therapist responses to client premature termination from psychotherapy. In Study 1, we surveyed therapists' attributions for client premature termination from therapy using an open response format. Results suggested that therapists showed a self-serving pattern in their attributions (i.e., attributed causality to the client or environment) when considering their own clients compared to when they considered the premature terminations of clients in general. Study 2 was a vignette study in which therapists responded to one of two client presentations that varied relationship to client (your client vs. other's client). Using the attributional categories derived from Study 1, therapists rated the likelihood that each attribution caused the client's premature termination. Again, patterns across groups indicated that therapists are self-serving in their attributions for client premature termination. In addition, differences were found across gender and theoretical orientation; larger effects were found for men compared to women, and psychoanalytic therapists compared to cognitive–behavioral. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client resistance as predicted by therapist behavior: A study of sequential dependence.

This study examined the relation of client resistant behavior to therapist directive behavior in a sample of 10 prominent archival therapy sessions. Client and therapist speaking turns were coded, with the behavior being aggregated into 1st-order 2?×?2 sequential frequency matrices for each dyad: one set with therapist behavior as antecedent and another set with client behavior as antecedent. The dependency of client and therapist behavior on the behavior of the other was considered across different dyads. The results indicated an overall trend, with therapist directive behavior slightly increasing the probability of subsequent client resistance. No similar effect of client behavior on subsequent therapist behavior was found. Implications of the findings with respect to research and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dropping out of treatment: A critical review.

After a discussion of methodological issues, literature on dropping out of treatment is critically reviewed in 6 areas: hospital treatment of general psychiatric and tubercular patients, outpatient treatment of internal medical conditions, alcoholism, heroin addiction, general psychiatric outpatient psychotherapy, and double-blind drug studies. 15 factors were found to predict dropping out in 100%, 83-88%, and 60-75% of the relevant studies: (a) social isolation and/or unaffiliation, therapist attitudes and behavior, discrepancies between patient and therapist treatment expectations; (b) passive-aggressive behavior, family attitudes and behavior, motivation, behavioral and/or perceptual dependence, psychological mindedness and/or denial, symptom levels and symptom relief, socioeconomic status, sociopathic features, alcoholism and/or drug dependence; and (c) age, sex, and social stability. (101/2 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists' personal therapy and professional self-awareness.

Surveyed 185 doctoral-level psychologists, averaging 16 yrs of experience, who responded to questions about their personal therapy histories and provided their professional reactions to 25 hypothetical psychotherapy situations. Results suggest that awareness of countertransference issues was highly significantly and positively related to the amount of personal therapy a therapist had received. Data also suggest a relationship between countertransference and the therapist claiming a psychoanalytic orientation, receiving personal therapy from a psychoanalytically oriented therapist, and having attended a psychoanalytically oriented training program. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Transference: Its meaning and function in psychoanalytic therapy.

Reviews the book, Transference: its meaning and function in psychoanalytic therapy by Benjamin Wolstein (see record 1955-01021-000). The book reflects the groping trends of opinion developing from therapeutic experience and from increased awareness of the problems of definition. Many questions related to transference are brought closer to the status of answerable questions. The author sees transference in terms of observable here-and-now behavior. He keeps the focus on present interactions with careful attention to the therapist as an interbehaving organism (countertransference) rather than as a hypnotic authority. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Termination from a psychoanalytic perspective.

The following principles of termination have been derived from the confluence of psychoanalytic and other perspectives: (a) The timing of the termination is determined by the patient; (b) the frequency of meetings should be reduced and a final appointment scheduled some time after the second-to-last meeting; (c) the patient's stressors, previous dominant ways, and new ways of responding should be reviewed; (d) what the patient believes was accomplished should be discussed, (e) the therapist should inquire what was helpful and hurtful; (j) the therapist should inquire, if appropriate, whether there is something negative about the therapy leading the patient to terminate; (g) the therapist should equalize the relationship; and (h) the patient should be invited to correspond in the future. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

List of therapist intentions illustrated in a case study and with therapists of varying theoretical orientations.

The Intentions List (IL), a 19-item list of therapist intentions, was developed and examined in 2 studies. In Study 1, the use of intentions was investigated in 20 sessions of time-limited therapy with a young neurotic female; 3 trained judges analyzed each session. Across-treatment decreases occurred in the following intentions: setting limits, getting information, supporting, clarifying, hoping, and catharting; increases occurred in insight, change, and reinforcing change. Within sessions, there were decreases in getting information, clarifying, and catharting. In Study 2, the IL was used by 42 experienced therapists in their sessions of ongoing treatment with a neurotic individual or family. MANOVA showed that 7 intentions predicted differential ratings of theoretical orientations. Univariate correlations indicated that feelings and insight were related to psychoanalytic ratings; change, reinforcing change, and setting limits were related to behavioral ratings; and "therapist needs" was related to humanistic ratings. All Ss followed a similar pattern of decreases in clarifying and getting information and increases in catharting, insight, and change. The quality of sessions was related to more focus and feelings and to less getting information and supporting. It is concluded that the IL is an empirically based, pantheoretical measure of therapists' cognitive behavior. (44 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Interpreting in the dark": Race and ethnicity in psychoanalytic psychotherapy.

Discusses the impact of race and ethnicity on the psychotherapeutic process of 3 patients in psychoanalytic psychotherapy with an African-American therapist. Race and ethnicity remain topics that engender anxiety in social and clinical discourse. Psychoanalytic literature on race has been hampered by incomplete conceptualizations and overgeneralizations that often limit its clinical utility. Clinical examples are used to explore the way in which attention directed at racial issues provides a framework for the treatment alliance and illuminates key transferences and resistances. Discussion of racial issues is most fruitful when racial themes are situated in bodily and social contexts and when the meaning that race has in the therapy dyad is negotiated by patient and therapist, apart from idealized or socially correct conceptualizations from outside of the treatment situation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The sticky metaphor in psychoanalytic therapy.

Explores the problem of the sticky metaphor (SM) in psychoanalysis and psychoanalytic psychotherapy. SMs are recurring themes in the therapy that seem to reappear throughout the treatment and are often associated with a repetitive screen memory. Understanding the adhesiveness of SMs may provide important data on both transference and countertransference issues in therapy. An SM may often result from a complimentary identification in the therapist, which may or may not also be related to the analyst's experiencing similar conflicts in his or her own personality. A case of SM in therapy with a 34-yr-old White man illustrates the recurrence of a metaphor based on an early traumatic experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A note on time lags in psychotherapy: Are transference interpretations enough?

Time-lags in psychoanalytic psychotherapy are considered in relation to the historical emphasis on reconstruction vs repetition in the transference. Implications for technique in psychoanalytic therapy are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The analysis of the transference in the here and now and Essential papers on transference analysis.

Reviews the books, The analysis of the transference in the here and now by Gregory Bauer (see record 1994-97149-000) and Essential papers on transference analysis, also by Gregory Bauer (see record 1994-97131-000). These are companion volumes which present an excellent, systematic understanding of Bauer's contemporary approach to Here and Now Transference Analysis in psychodynamic and psychoanalytic practice. The here-and-now method highlights the use of the affective immediacy of the relationship between the patient and therapist to "clarify, explore and modify interpersonal conflict rather than as a springboard for discussing the genetic determinants of conflict." Bauer focuses on reactions and behavior patterns that are transference based, as opposed to focusing on the transference neurosis seen as the systematic development and interpretation of fantasies and attitudes that are highly organized and displaced onto the therapist. The former is viewed as a less intense variation of the latter; both are felt to be a part of the same transference continuum. Bauer's volumes provide the clinician with an excellent overview and primer on Here and Now transference analysis, as well as its history, conceptual underpinnings and techniques for using it in the therapeutic relationship. The analytic and psychodynamic practitioner alike will find these books an invaluable addition to their professional libraries. (PsycINFO Database Record (c) 2010 APA, all rights reserved)