Psychotherapy, professional relationships, and ethical considerations in the myspace generation.

The pervasive use of Internet technologies has created new ethical dilemmas for psychology trainees and professionals. In particular, Web sites that allow users to post personal information have sparked controversy regarding the amount of freedom psychologists should have in placing personal information online and how discovering such information may impact professional relationships, including the therapeutic relationship. Results from a graduate student survey (N = 302) address the prevalence of the use of online social networking sites, security measure efforts that limit public access, incidents of client access to psychotherapists’ personal Web sites and Internet use by psychotherapists to obtain client information, and their subsequent effect on the therapeutic relationship. Using applicable ethical principles and standards, we provide recommendations for the field in an effort to decrease potential harm and maximize areas of opportunity for psychologists and constructive professional relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An analysis of professed psychotherapeutic techniques.

Psychotherapeutic technique is commonly assumed to be an important source of variance in the process and outcome of psychotherapy. It was postulated that at least 3 dimensions are essential to adequately characterize therapeutic technique. The hypothesized dimensions were psychoanalytic, impersonal vs. personal, and directive techniques. An inventory to assess therapeutic technique preferences was constructed and administered to 265 psychotherapists. 3 independent hypothesized factors were confirmed. Pattern scores of therapists on the factors related to their profession, sex, and amount of personal psychotherapy, but not to experience. The results provide a basis for classifying psychotherapists according to their characteristic techniques and for studying the effects of technique on treatment process and outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Good, the Bad, the Obligatory, and the Virtuous: The Ethical Contexts of Psychotherapy.

Specific psychotherapy sessions and psychotherapy in general exist in the context of ethical questions and answers. Although psychotherapists often avoid them, questions about what is good, what is bad, obligations, and virtues (relatively stable, valued personal qualities) are an inescapable part of psychotherapy. Some ways psychotherapy raises (and answers) those questions are discussed in the context of a clinical case. The potential for ethical convictions to spark ethical conflict and divisiveness is explored, as is the potential for particular sorts of explicit reflectiveness about the ethical character of psychotherapy to be constructive and integrative. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A legal and ethical review of patient responsibilities and psychotherapist duties.

The ethics and standards of practice literature has long focused on the duties that psychotherapists owe their patients. While this has been valuable to the profession, it has created a circumstance in which psychotherapists have focused on their duties and responsibilities to their patients with little understanding or respect for how the conduct of a patient can impact those factors. These articles will review these factors from both an ethical and legal perspective. In addition, all of the articles discuss the premise that, while the psychotherapist has the primary responsibilities when rendering treatment to a patient, the treatment alliance is actually a dynamic that changes depending upon the conduct of both the psychotherapist and the patient. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Moral issues in psychotherapy.

"The first moral obligation of the psychotherapist is to be competent. The more skillful he becomes, the better he fulfills his main ethical responsibility." 4 typical examples of moral issues which arise frequently in the practice of psychotherapy are specified. "One of the falsehoods with which some therapists console themselves is that their form of treatment is purely technical, so they need take no stand on moral issues… . The illusion that our art transcends morality has kept us from forthright study of the ethical and religious disciplines. We psychologists would take a dim view of any experts in philosopy and religion who might hang out a shingle to practice psychotherapy. We would deplore their lack of training in our discipline. My thesis is that scholars in religions and ethics have a right to take an equally dim view of most psychotherapists." The "meaning and contribution of psychotherapy will be enlarged as its practitioners add to their growing technical competence a broader and deeper realization of life's persistent ethical problems." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of A perilous calling: The hazards of psychotherapy practice.

Reviews the book, A perilous calling: The hazards of psychotherapy practice by Michael B. Sussman (1994). In this book, the author presents chapters by therapists from various disciplines (e.g., psychology, social work, psychiatry) that examine the "hazards" that lay hidden in the practice of psychotherapy. The author contends that doing psychotherapy "poses significant dangers to clinicians" (p. 1). He believes that there are forces both internal and external to the therapist that may take their toll on the therapist's well-being. Sussman makes the point that while other overtly dangerous professions (e.g., firefighter) warn prospective candidates of the perils of their field, novice psychotherapists are not prepared for what awaits them. Psychotherapists, then, enter the profession unprepared for, if not blind to, possibilities that not only make them less effective in their work, but might actually harm themselves and their families. Sussman sees a real human cost to not preparing clinicians to be aware of, and deal with, these hazards. The book is divided into six parts that range from the therapist's personal development to renewal. Along the way the reader encounters professional, ethical and legal issues, clinical dilemmas, the emotional impact of the work, and the ailments of the therapist. Within each particular area are rather personal, and at times idiosyncratic, chapters from a variety of psychotherapists. There are chapters that deal with AIDS, the Holocaust, body shame, and being a female therapist. Most of the chapters have a distinctly clinical orientation, while a few come across as philosophical discourses. There is one chapter by an expert witness in the Margaret Bean-Bayog case who warns of the dangers of the press on one's career. The wide scope of the chapter topics, at times, gives the book a disjointed feel and the sense that it is trying to tackle too many issues at once. Overall, this book provides a new slant on what is involved in the practice of psychotherapy. It raises some important questions about the field and how we prepare for its impact on our lives, for the practice of psychotherapy surely does affect the practitioner. Sussman and some of the chapter authors make a good case for increasing communication about potential hazards and developing strategies and training methods that will minimize their effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The therapist's therapist: A replication and extension 20 years later.

How do mental health professionals choose their own psychotherapists? This study replicates and extends a 1987 national survey of psychotherapists regarding the selection criteria and sociodemographic characteristics of their personal therapists; 608 psychologists, counselors, and social workers participated. Therapists' therapists tended to be middle aged and White (94%) but equally female and male. Their most frequent theoretical orientations were integrative, eclectic, cognitive, and psychodynamic (but rarely behavioral or systemic). Psychology was their most prevalent profession, followed by social work, counseling, and psychiatry. Topping the list of therapist selection criteria were competence, warmth, experience, openness, and reputation. The prototypical positive features of personal treatment that therapists repeated with their own patients all concerned cultivation of the therapeutic relationship. The 2007 results are tentatively compared with those obtained in 1987, thus chronicling the evolution of therapists' therapists over the years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The psychotherapist's own psychotherapy: Patient and clinician perspectives.

Reviews the book, The psychotherapist's own psychotherapy: Patient and clinician perspectives by Jesse D. Geller, John C. Norcross, and David E. Orlinsky (2005). The editors of this book have two aims: 1) "to synthesize and explicate the accumulated knowledge on psychotherapy with psychotherapists," and 2) "to provide clinically tested and empirically grounded assistance to psychotherapists treating fellow therapists, as well as to those clinicians who seek personal treatment themselves." The editors seem to be walking a fine line between asserting their own integrative conclusions and setting the conditions for readers to arrive at conclusions on their own. The tendency is toward the latter. With this propensity in mind, readers might approach the book as a truly encyclopedic collection- best approached in piecemeal (nonintegrative) fashion, focusing on fascinating morsels that can stand alone. In contrast, for those readers who are drawn toward integration, the book may elicit contrasting experiences of deep familiarity and understanding, and disorienting befuddlement about what was just read. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapists in South Korea: Professional and Practice Characteristics.

Using data collected as part of a collaborative international study of the development of psychotherapists (D. E. Orlinsky et al., 1999), the authors of this study describe a sample of 538 Korean psychotherapists in various mental health professions and also provide information about the cultural and historical background of psychotherapy in South Korea. The study delineates the professional identifications, training, theoretical orientations, career status, personal therapy, and demographic characteristics of this little-known group of psychotherapists and describes their treatment settings, clients, and typical treatment modalities. The use of Western therapeutic approaches in a non-Western cultural context is discussed with respect to the potential conflicts for practitioners between imported methods that embody individualistic values and the traditionally collectivist orientations of their societies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensions of psychotherapists' activity.

2 samples of psychotherapists (N = 59 and N = 248) responded to a 17-item scale sampling the usual practices of psychotherapists. Factor analysis, performed separately for each sample, yielded 6 factors, only 4 of which were sufficiently clear to lend themselves to interpretation. Factor I, concerned with the maintenance of personal distance, was by far the strongest factor. The remaining factors referred respectively to preference for intensive psychotherapy, preference for keeping verbal communications to a minimum, and viewing psychotherapy as an artistic activity that should be flexibly applied. The need for further work to arrive at better delineations of the several factors was stressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Becoming psychotherapists: Experiences of novice trainees in a beginning graduate class.

The authors investigated the experiences related to becoming psychotherapists for 5 counseling psychology doctoral trainees in their first prepracticum course. Qualitative analyses of weekly journals indicated that trainees discussed challenges related to becoming psychotherapists (e.g., being self-critical, having troubling reactions to clients, learning to use helping skills), gains made during the semester related to becoming psychotherapists (e.g., using helping skills more effectively, becoming less self-critical, being able to connect with clients), as well as experiences in supervision and activities that helped them cope with their anxieties. Results are discussed in 5 broad areas: feelings about self in role of psychotherapist, awareness of reactions to clients, learning and using helping skills, reactions to supervision, and experiences that fostered growth. Implications for training and research are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment failures in private practice: How do psychologists proceed?

Very little is known about how psychotherapists proceed when patients fail to progress. Psychologists in independent practice (N = 591) were surveyed regarding their approach to treatment failures in an updated partial replication of P. C. Kendall, D. Kipnis, and L. Otto-Salaj (1992). Overall, practitioners reported seeing patients a median of 12 sessions before concluding no progress was being made and relying on colleague consultation and clinical experience to formulate their next steps. Practitioners of different orientations varied on treatment duration and ensuing strategies. Specifically, psychodynamic practitioners treated patients significantly longer than cognitive-behavioral and eclectic practitioners before concluding treatment failure. Cognitive-behavioral and eclectic practitioners were more likely than psychodynamic practitioners to utilize treatment materials informed by psychotherapy outcome research and to refer patients to other clinicians. The ethical and practical implications of handling treatment failures in private practice are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Utilizing technological innovations to enhance psychotherapy supervision, training, and outcomes.

Recent technological advances in the use of the Internet and video technologies has greatly impacted the provision of psychotherapy and other clinical services as well as how the training of psychotherapists may be conducted. When utilized appropriately these technologies may provide greater access to needed services to include treatment, consultation, supervision, and training. Specific ethical challenges and pitfalls are discussed and recommendations are made for the ethical use of these technologies. Additionally, innovative practices from the seven articles in the special section that follows are highlighted and reviewed. These articles present a number of innovations that can take psychotherapy training, research, supervision, and treatment forward toward increased effectiveness. Recommendations for integrating these innovations into ongoing practices are provided and for additional research to build on the important work of the authors in this special section are provided. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Processes and outcomes of psychotherapists' personal therapy: Replication and extension 20 years later.

In this replication and extension of a national survey of psychotherapists conducted in 1987, American psychologists (n = 219), counselors (n = 191), and social workers (n = 192) reported in 2007 on the processes and outcomes of their personal therapy experiences. Of the 85% who sought therapy at least once, women, men, and members of all three professions were equally as likely to have received personal treatment. Their top reasons for seeking therapy were marital–couple distress (20%), depression (13%), need for self-understanding (12%), and anxiety–stress (10%). Approximately 24% used psychotropic medication in combination with personal therapy. More than 90% of therapists reported positive outcomes across multiple domains. The modal lasting lessons from personal treatment related to therapist reliability, skill, and empathy. The results are tentatively compared with those obtained in 1987, thus chronicling the evolution of personal therapy among psychologists and social workers during the past 20 years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Independent practice in child and adolescent psychotherapy in small communities: Personal, professional, and ethical issues.

This article addresses issues faced by independent practicing child and adolescent psychotherapists in small-town settings. A community approach to delivering services is stressed. Personal, professional and ethical dilemmas are explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy in the Remediation of Psychology Trainees: Exploratory Interviews With Training Directors.

Practicing psychotherapists and trainers of psychology doctoral students are often concerned about the role of personal psychotherapy for trainees, particularly when intended for remediation. The training directors for 14 doctoral programs were interviewed regarding the use of personal psychotherapy for remediation. The major theme in a qualitative analysis of these exploratory interviews was the challenge of balancing confidentiality of the trainee's personal therapy with training program accountability and quality assurance to protect the public. Program practices ranged from hands-off to active program involvement in aspects of the trainee's personal therapy. Recommendations for program decision making about psychotherapy as remediation for trainees are suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personal therapy in the training of psychologists.

Surveyed 185 clinical and counseling psychologists in British Columbia about their opinions on personal therapy as a component of professional training, and about the circumstances under which personal therapy had been provided to them while they were in graduate school. Ss identified potential benefits and risks of personal therapy. 88% saw at least 1 benefit for the experience, and 83% saw at least 1 risk. 41% of Ss had undergone therapy as part of their clinical training, and in many cases this experience was provided in a manner inconsistent with ethical guidelines. Of those receiving personal therapy, 46% reported that therapy was required rather than optional. Ethical issues concerning therapeutic interventions in the training of psychotherapists are discussed. A French summary of the article is also presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Licensing Board Complaints: Minimizing the Impact on the Psychologist's Defense and Clinical Practice.

Most psychologists who face board complaints experience significant personal and professional distress. As a result, they become vulnerable to cognitive, emotional, and behavioral responses that may compromise their clinical work as well as their ability to defend themselves. Awareness of some of the most common sources of distress associated with complaints can allow psychologists to take steps to minimize, if not obviate, problematic countertransference, impaired objectivity, and self-defeating responses throughout and beyond the complaint investigation and adjudication process. Further, awareness of these pitfalls can inform the work of the supervisors, consultants, and psychotherapists who assist psychologists facing ethics complaints. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Rehearsals for growth: Theater improvisation for psychotherapists.

Reviews the book, Rehearsals for growth: Theater improvisation for psychotherapists by Daniel J. Wiener (see record 1994-98676-000). This book is clearly written for psychotherapists who might be interested in improv and improv's applications to the psychotherapeutic stage, and not for actors and actresses studying psychotherapy. The style of the book is unique. It is a weave of personal narrative, literature review, interviews with improv teachers, practical ideas, and case material. It is also written so that after a brief introduction one may play with the book as one likes—it can be read cover to cover; one can go directly to practical ideas; another can study the content chapters in any order; and so on. I read the book cover to cover, and the shifts is presentation style felt disruptive, but this might be the very improv principles at work in the author's writing style. Probably the most useful part of the book is the bounty of ideas, games, and exercises. These techniques are described in text and tabulated in an appendix for easy reference and comparison. The games and exercises are playful, thought-provoking, maybe even iconoclastic, and potentially therapeutic with a skilled therapist. The book is worthwhile for almost any psychotherapist from any therapeutic modality. The challenge, though, for those that accept it, doing what it takes to develop genuine and reliable spontaneity. Rehearsals for Growth is one method to achieve that aim. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Keeping our instruments finely tuned: An existential–humanistic perspective.

Discusses psychologist self-care from an existential-humanistic point of view. The authors use the metaphor of a musician fine-tuning her instrument to illustrate that psychotherapists should, like the musician, seek to be in communion with their own aliveness—with their personal life force that is the instrument. It is stated that if one neglects to maintain this connection, burn out is possible. Listed are ways in which psychotherapists can avoid a disconnection from this aliveness and seek this communion, in turn allowing psychotherapists to have a grounded conception of their own responsibilities and those of their clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)