The training psychotherapist in a therapeutic community.

Discusses the impact of a therapeutic community on the training psychotherapist and indicates potential difficulties in working with psychotic patients in a setting that demands personal vulnerability and that may reawaken the therapist's yearnings for communal participation and belonging. The psychotherapist may develop a communal transference as a result of his/her repressed communal object-hunger. The "mad psychotherapist" "Dr. Doctor," and the "nag therapist" characterize defensive postures taken by psychotherapists dealing with the stress of treating psychotic patients in a therapeutic community. As a result of their communal participation, therapists have the opportunity to work through this transference which then enhances their psychotherapeutic efforts. The psychotherapist further matures when toward the end of training, he/she confronts the social reality of the patients' continued hospitalization. The therapist's role in assisting the social rehabilitation of his/her patients is discussed. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the enduring and substantial influence of Carl Rogers' not-quite necessary nor sufficient conditions.

Carl Rogers' 1957 paper (see record 2007-14639-002) is arguably the most successful of his many attempts to clarify and render testable the ideas behind client-centered therapy. While each of the conditions that Rogers postulated has been linked to positive therapeutic outcome, taken together they have never been conclusively proved (nor disproved) to be either necessary or sufficient for positive outcome. Nevertheless, the overriding "take-home" message in this classic paper--that the therapist's attitude and caring presence is critical for therapeutic success--is one that has had virtually unparalleled influence in every segment of the psychotherapeutic community. Clinical and theoretical innovations in the psychoanalytic community serve as examples of the following proposition: that Rogers' concepts, while accepted more than ever by a remarkably wide variety of psychotherapists, remain essentially unacknowledged as originating with him or in the tradition of humanistic and client-centered therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The rational treatment of multiple personality disorder.

The complex symptomatology of patients who have survived profound childhood abuse, particularly the severe dissociative and posttraumatic symptoms of patients with multiple personality disorder (MPD), may predispose therapists to engage in poorly considered psychotherapeutic practices. Therapists should be careful to keep a rational clinical perspective and not to be distracted by patients' unusual and dramatic clinical presentation. This article discusses the particular problematic areas often encountered in the treatment of MPD patients, including the necessity for pacing the therapy, keeping the focus on the patient as a whole, and avoiding preoccupation with individual personalities or with MPD phenomenology. Clinical vignettes illustrate these areas of difficulty. Good clinical judgment and sound therapeutic principles permit rational and productive treatment even for challenging MPD patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Awards for Distinguished Professional Contributions.

Discusses contributions made by Leopold Bellak, Harry Levinson, Herbert Freudenberger, J. Wilbert Edgerton, and Gerald P. Koocher, recipients of the Awards for Distinguished Professional Contributions awarded by the American Psychological Association. Bellak is recognized for contributions to the fields of psychopathology, psychoanalysis, psychological testing, brief psychotherapy, and community mental health. Levinson is awarded for application of psychological theory to the daily functioning of organizations. Freudenberger is recognized for instilling the principles of trust, respect, and human dignity into the psychotherapeutic process. Edgerton is awarded for the development of rural mental health services (MHSs) and the enhancement of MHSs in the public sector. Koocher is recognized for public service activities, including children's legal rights and protection of consumers of MHSs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive emotions as generators of therapeutic change.

The purpose of this article is to highlight commonalities and facilitate links between the domains of psychotherapy and positive psychology. The authors describe the Broaden-and-Build theory and suggest that it has heuristic value for understanding psychotherapeutic processes. The authors propose that broadening represents a common factor in intrapersonal therapy that contributes to many helpful change events across different psychotherapies. The upward spiral in which positive emotions and broadening feed one another enlarges current psychotherapeutic conceptualizations by suggesting that positive emotions are not just indicators but also generators of change. The positive emotion-broadening spiral offers new avenues for research and ways to understand existing research, an alternative avenue to therapeutic change, and a method to tailor therapeutic work to individual clients. It also bridges researcher, clinician, and client points of view about key change events. Links between different viewpoints enhance therapeutic work. Links across lines of theorizing and research foster interdisciplinary ties that fertilize both fields. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religious language in psychotherapy: Dyadic and triadic configurations.

In this article, clinical material from 3 patients with psychotic liabilities who introduced religious cosmologies into the psychotherapeutic situation is examined. These constructions did not occur in the context of an ongoing faith experience or long-standing participation in a religious community. One way of understanding these narratives is through dyadic and triadic configurations. In some cases, the introduction of a God representation is an attempt to withdraw from the therapeutic dyad into one of more omnipotence, promise, and hope. In others, the introduction of the God representation serves the purpose of locating a lawful Third to the regressive forces of the therapeutic dyad. The purpose of the Third is to structure the roles and relationships of the participants and to moderate the effects of regression inherent in a dyadic configuration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specific and nonspecific factors in psychotherapy: A problematic paradigm for psychotherapy research.

Discusses the specific/nonspecific hypothesis—a paradigm that has guided psychotherapy research for the last 3 decades—and suggests that underlying this hypothesis is the assumption that research can ultimately separate and assess the relative contributions to psychotherapeutic outcome of specific and nonspecific factors. This assumption, in turn, has held the promise that specific, active ingredients of psychotherapy could be identified. Categorical rejection of the specific/nonspecific hypothesis is advocated. It is suggested that the identity of psychotherapy with its interpersonal context must be acknowledged. In this way, the goal of psychotherapy research shifts from the search for active ingredients toward efforts to identify fundamental principles of human interaction that underlie the interpersonal conditions essential for therapeutic change. (63 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward a participatory model of psychotherapy.

A pervasive model of the psychotherapeutic relationship has assumed that patient welfare is best served by the therapist's exercise of control over and responsibility for methods, goals, and decisions in treatment. However, increased sensitivity to ethical dilemmas in the routine conduct of therapy and more vocal demands by the users of mental health services are likely to lead to a restructuring of the psychotherapeutic relationship. A mutual participatory model of therapy is advocated that would give a central place to active, skeptical efforts by the patient to be informed and to share responsibility for therapeutic decisions. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotion and cognition in psychotherapy: The transforming power of affect.

Theory and research on emotion in both psychology and psychotherapy are reviewed to demonstrate the importance of emotion in human functioning and psychotherapeutic change. A proposal is made for the importance of integrating empirically supported emotion-focused change processes into psychotherapeutic work. Five principles of change in the emotion domain-emotion awareness; expression; regulation; reflection on emotion; and the more novel principle of emotion transformation, by which emotion is changed by emotion-are offered as processes of change that are rapidly gathering empirical support. The result of emotion coming of age will be the expansion of theories of dysfunction and of treatment to include emotion-focused coping and emotional processes of change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy, Classism, and the Poor: Conspicuous by Their Absence.

Four decades of research have delineated the need for improved psychotherapeutic opportunities for poor clients, yet psychotherapists remain contradictory in their stance regarding service to the poor. Despite periodic calls within the field to address the needs of poor people, evidence from the psychotherapeutic literature suggests that the poor are still largely absent from consideration. What barriers prevent psychotherapists from enacting their professional principles more consistently on behalf of poor clients? The author suggests that unexamined classist assumptions constitute a significant obstacle for practitioners and presents the experience of confronting her own classism to illustrate the operation of these attitudinal barriers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differentiating multiple relationships from multiple dimensions of involvement: Therapeutic space at the interface of client, therapist, and society.

This article focuses on redirecting current thinking from multiple relationships to the multiple dimensions of our involvements with clients. Given that people's readiness for human involvement is both desirable and unavoidable, recognizing and managing these multiple dimensions of involvement is at the heart of professional interactions. A triangular space, formed at the intersection of societal, therapist and client features, forms the framework in which therapeutic work occurs. In practice, a balance should be maintained within and among five principles of clinical and ethical practice. These are beneficence, respect for client autonomy, self-awareness, self-interest, and openness to objective input. An applied section considers the sources of imbalance in the proper management of the multiple dimensions of therapists' involvements in the psychotherapeutic relationship via a brief consideration of two case situations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research into the psychosocial aspects of ENT tumor surgery (excluding laryngectomy). 4: Status of research and future research goals

The literature on the psychosocial aspects of head and neck cancer surgery from 1950 to 1995 was reviewed in four parts. In the present Part 4 ten possibly useful targets for future research are formulated: 1. An increase in the comparability of research data; 2. Comparisons of therapeutic alternatives; 3. Identification of psychosocial high-risk patients; 4. Studies on psychotherapeutic interventions; 5. Expanded of the knowledge about preventive work; 6. Searches for new possibilities for widening communication by the treating team; 7. Better understanding of ethical restrictions to surgery; 8. Exploration of psychosocial factors with potentially etiologic importance; 9. Methods for using qualitative approaches to research; 10. Creation of a community of researchers.     

The social–cognitive construction of psychotherapeutic change: Bridging social constructionism and cognitive constructivism.

Self-with-other processing and construction play an important role in human adjustment, development, and change. This idea is critical for an adequate understanding of psychotherapy and psychotherapeutic change. A theory of psychotherapeutic change that combines elements of both social constructionist and cognitive constructivist thought is presented briefly. After reviewing salient examples of both forms of thought as these have manifested in theorizing about psychotherapeutic change, a sampling of original empirical demonstrations is offered in support of the theory. Psychotherapeutic change is described as a process of appropriation and practical application through which clients internalize therapeutic conversations and activities, which they then use as psychological tools to restructure personal theories, experiences, and actions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological services in rehabilitation medicine: Clinical aspects of rehabilitation psychology.

Reviews the role of the psychologist in a rehabilitation medicine setting, with emphasis on the application of traditional clinical and counseling skills to psychological problems encountered by the physically disabled. Briefly reviewed are the rehabilitation perspective, issues of adaptation and personality, psychodiagnostic and psychotherapeutic consultation, and behavioral principles. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differentiation of resources in mental health delivery: Implications for training.

The following mental health delivery systems, which include a variety of "movements" or approaches, are briefly differentiated and reviewed: prevention, self-help groups, social-skills training problems, psychotherapeutic interventions, environmental modification, and community resources. The implications of this differentiation for training in clinical psychology are discussed. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of therapists' illness or accident on psychotherapeutic practice: Review and discussion.

Few therapists give thought to the potential impact of future personal illness or accident on their psychotherapeutic practice. Unfortunately, most therapists will experience varying degrees of physical disability during their careers, but few have prepared for the various issues and problems related to clinical practice which typically arise as a result. We summarize and review the available literature on this topic, examine those factors that often threaten psychotherapeutic practice as a result of the therapists' illness or injury, and provide several practical guidelines and suggestions for minimizing its negative impact on the client and the therapeutic relationship. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychotherapeutic relationship.

This paper attempts an exhaustive review of the literature on the psychotherapeutic relationship. The nature of the ideal psychotherapeutic relationship is defined and approximations of this ideal are shown to correlate positively with various measures of patient progress in the therapeutic enterprise. Other correlates of good therapeutic relationships are then explored: patient variables, therapist variables, therapist-patient similarity, and technique variables. In all these areas, significant correlations are found, though not as often as one might expect. The research on therapist variables is especially disappointing, while patient variables seem to be quite good predictors of the quality of the ensuring patient-therapist relationship. Methodological issues are considered throughout the paper. (72 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hospital psychiatry in transition. From the therapeutic community toward a rational eclecticism

Concepts derived from the paradigm of the therapeutic community have provided the main organizing principles for general inpatient psychiatry in the past 20 years. Increasingly, however, scientific studies have thrown doubt on the efficacy of current hospital practices. Changes in the broader social milieu have occurred as well since the therapeutic community was originally conceptualized, which raise questions about the "fit" between milieu therapy principles and current psychiatric needs. No current therapeutic paradigm is sufficient to encompass current inpatient psychiatric practice. There is a need for flexibility in utilizing various organizing principles for various aspects of the problems at hand. The paradigm of "problem-solving," derived from the research findings comparing group vs individual problem-solving, is an example of one way of examining and organizing data that could be applied to certain aspects of hospital care.     

Goodwin Watson's 1940 conference.

M. R. Goldfried's (see record 1981-28393-001) proposed conference had a precursor in a meeting chaired by G. Watson. Its goal was to ascertain areas of agreement among psychotherapeutic approaches. The consensus included an emphasis on the centrality of the therapeutic relationship. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The ritual as a psychotherapeutic intervention.

Examines ritual as a tool for psychotherapeutic application with clients experiencing grief, trauma, anxiety, and family dysfunction. Case vignettes are provided to illustrate the therapeutic properties and creative power of rituals as interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)