The rural psychologist as generalist: A challenge for professional identity.

Discusses how the psychologist who practices in a rural mental health facility performs many tasks identical to those done by other mental health professionals. While a nonpluralistic and financially constrained mental health system is best served by flexible professionals with a wide range of skills, psychologists in such a setting must utilize their unique training to establish their identity among the service providers. The unique identity of the psychologist is found in the heritage, perspective, and methodology of psychology and not just in clinical activity. Psychologists should begin to develop their methodology by using the larger university context in which they were trained and thereby establish themselves also as researchers and community psychology practitioners. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The professional identity of the nurse: concept analysis and development

Urea kinetics were measured in normal women after 5 d consuming a low protein diet [LP, 67 mg N/(kg.d), 0.42 g protein/(kg.d)]. To determine whether the availability of methionine limits the utilization of nonessential nitrogen from low protein diets, the study was repeated on four further occasions with the addition of dietary supplements of L-methionine, 9 mg N/(kg.d) (LP-M); urea, 52 mg N/(kg.d) (LP-U); urea and methionine (LP-UM); or urea, 26 mg N/(kg.d), and glycine, 26 mg N/(kg.d), (LP-UG). Urea kinetics were derived after prime and intermittent oral doses of [15N15N]urea from the measurements of enrichment by isotope ratio mass spectrometry in urea isolated from urine. Nitrogen balance was significantly improved when the women consumed LP-U and LP-UG, but not LP-M or LP-UM. The urinary excretion of 5-L-oxoproline was measured as a marker of glycine availability and was significantly lower when women consumed LP-U and LP-UG compared with either LP or LP-M and LP-UM. There was a significant correlation between urinary 5-L-oxoproline and urinary sulfate excretion (r = 0.68, P = 0.00003). The availability of methionine was not limiting for nitrogen metabolism when women consumed these diets, whereas the response to supplementation with urea alone or urea with glycine showed that the availability of nonessential nitrogen was limiting. Glycine is consumed in the detoxification of excess methionine, and supplementation with methionine appeared to place a competitive demand on the availability of glycine for other metabolic processes.     

Countertransference management.

The empirical literature on countertransference (CT) and, in particular, CT management as they relate to immediate, proximate, and distal treatment outcomes, is examined. Although there is a paucity of research connecting CT and its management to distal outcomes, the existing empirical literature strongly supports the idea that the acting out of CT hinders therapy, whereas effective CT management aids treatment. A theory of five factors that are central to CT management has received provisional empirical support and is described here. These factors are self-insight, self-integration, anxiety management, empathy, and conceptualizing ability. Further research is needed on the relation of CT and its management to distal outcomes, and on how CT management operates and affects treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training for professional psychology: Science, practice, and identity.

The realization of coherence (an orderly world) can occur as a result of personal control (egocentric) or because persons are immersed in a decentralized community system (sociocentric). In this article, effects of the prevailing egocentric metaphor on professional psychology training and identity are described. The positivist empiricist model of science has provided unintentional elaboration of the egocentric metaphor in professional education. Some consequences in professional training are illuminated by what is condoned (power, sexism) as well as by what content is minimized (cross-cultural psychology, primary prevention). The role of values in an expanded vision of human science can provide a basis for implementation of a sociocentric metaphor in professional training and identity confirmation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward an identity for school psychologists: Beyond Starkman's professional model.

Comments on S. Starkman's (see record 1967-01982-001) discussion of the dilemma posed by the communicative and decision-making behavior of school psychologists and school superintendents. Starkman contends that paradoxical communication on the part of superintendents inhibits the freedom of school psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference: A Social Relations Perspective.

Countertransference (CT)-therapists' perceptions of and reactions to their clients-falls within the broader domains of interpersonal perception and relations. Therefore, social psychological paradigms may prove useful for studying this phenomenon. The authors demonstrate how D. A. Kenny's (1994a) social relations model (SRM) can provide a useful approach for studying CT. Specifically, the SRM distinctions among target, perceiver, and relationship variance were used to understand some of the theoretical developments within clinical CT literature. The authors also suggest that findings from prior SRM research may have implications for issues within the CT literature. A sample of prior empirical research on CT was reviewed from an SRM perspective, and the authors offer suggestions for future CT studies using the SRM. Finally, the authors discuss the implications of this approach for psychotherapy integration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Issues in the professional development of psychotherapists: Countertransference and vicarious traumatization in the new trauma therapist.

Describes countertransference responses that are common to work with survivors of chronic childhood trauma. The phenomenon of vicarious traumatization (i.e., the impact on the therapist's psyche of empathic engagement with trauma survivors) is also examined. Both aspects of trauma therapy are framed in light of their particular impact on new trauma therapists. New trauma therapists often experience rescue fantasies and intense preoccupation with childhood trauma patients. They may also experience a voyeuristic countertransference response. Organizational and personal factors that can ameliorate these negative correlates of trauma work are described. By proactively addressing these issues, organizations, training programs, supervisors, and therapists can promote the personal and professional development of new clinicians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The comparison of White racial identity attitudes among faculty and students: Implications for professional psychologists.

Research on the influence of racial differences in multicultural therapeutic relationships has shown racial identity attitudes to be a critical factor in determining therapeutic relationship quality and therapeutic outcomes, such as premature termination (J. E. Helms, 1990). The Racial Identity Interaction Model was proposed to explain cross-cultural relationships in social dyads and groups where power differentials exist (Helms, 1990). Results are combined from 2 previously published studies to determine whether differences in racial identity exist in the faculty–student relationship. White racial identity attitudes of faculty and students were examined, and differences were obtained. Gender differences in attitude were also found. Implications for providing psychological services in an environment with increasing racial tensions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of professional identity in Black clinical psychology students.

Professional identity was conceived and explored via a sample of Black clinical psychology students. Theoretical perspective, values, and career goals were identified as the central aspects of professional identity. Sociopolitical professional identity (SPI) was of special interest; it was defined as a pattern of interdependence between sociopolitical values and other aspects of professional identity. SPI, which develops during the process of professional socialization (i.e., training), was predicted to occur more frequently in programs with a greater number of program resources relevant to work with culturally diverse populations. There was some evidence that significant and meaningful interdependent relations existed among the SPI variables, but there was no convincing evidence of an association between resource use and SPI. Nonetheless, the students used and apparently valued program resources such as Black faculty and culturally diverse training experiences. Other findings indicated that students were shaped by their training experiences, often in a way that reflected the dominant perspectives in clinical psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference as a prototype: The development of a measure.

Countertransference is a concept that is widely acknowledged, but there exists little definitional consensus, making research in the area difficult. The authors adopted a prototype theory (E. H. Rosch, 1973a, 1973b; see C. B. Mervis & E. Rosch, 1981, for a review) to examine this construct because it conceptually fits well with constructs that elude explicit definition. In Study 1, 45 experienced psychologists highly agreed with the prototypicality of 104 different examples of countertransference providing support for the presence of a prototype. In Study 2, the usage of this prototype in a sample of 35 trainees was related to ability to perceive countertransference in a case example drawn from the literature and positively correlated with self-reports of their experiences of countertransference but not with their self-reported ability to manage countertransference once it was manifest. Implications for training and research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Shame: Countertransference identifications in individual psychotherapy.

Shame is a universal experience felt by patients and therapists alike. Yet, the experience of shame, with its profound sense of inadequacy and worthlessness, is anathema to the competent and compassionate self-image of most therapists. In order to help therapists understand their own shame and their countertransference identifications to patient shame, this article first describes the nature of shame, its developmental progression within interpersonal relationships, and the defenses commonly employed to cope with shame. Because the experience of shame involves the activation of devalued and devaluing internal representations, therapists may develop concordant or complementary countertransference identifications. These countertransference identifications are influenced further by the patient's primary reaction to shame' which includes withdrawal, attacks on self, avoidance, and attacks on others. Each of these reflects a habitual reaction to shame that is displayed in the patient–therapist relationship. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Still different after all these years: Gender differences in professional identity formation.

We consider issues affecting professional identity formation, such as individual differences, graduate training, cultural perspectives, and ideology. We propose that gender differences in professional identity and functioning also are attributable, to a significant degree, to early developmental experiences. We review the professional socialization process and then discuss three theoretical issues related to gender differences that appear to affect women in their professional roles: a relational focus, distance vs. intimacy in relationships, and contextual decision making. We explore the theoretical issues under consideration and offer observations from personal experience in professional roles that are related to these theoretical concepts. We offer recommendations for training programs, the workplace, and further research concerning the impact of these issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychoanalysis and the disenfranchised: Countertransference issues.

This article examines basic psychoanalytic principles and their applications to the understanding and treatment of individuals not historically included in psychoanalytic formulations. It looks at the impact of culture, ethnicity, and class, but particularly poverty. The hope is to develop successful application of psychoanalytic theory and technique to the psychological problems of people living in poverty. Careful examination of their psychological reality may offer a unique opportunity to broaden vision of assessment to what constitutes dysfunctional condition, the concept of adaptation, the development of the working alliance, the nature of resistance and transference reactions, and the like. The analyst's personal discomfort, motivations, and stubborn adherence to specific theoretical and technical stances are considered the most damaging obstacles in this endeavor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference, attachment, and the working alliance: The therapist's contribution.

This study examined the relationship among therapist attachment styles, countertransference behaviors, and working alliance. Fifty therapists in training and their supervisors participated in the study. Therapists completed a self-rated measure of attachment style and a measure of working alliance with 1 of their clients. Supervisors completed measures of working alliance and countertransference behaviors about their supervisee's relationship with the same client. Results indicate that therapist attachment style did not correlate with either countertransference behaviors or working alliance. However, negative countertransference was associated with poorer working alliances, and positive countertransference was related to a weak bond within the working alliance. Additional analyses indicate that disagreement among supervisors and therapists about the bond component was predictive of countertransference behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The pregnant therapist: Countertransference dilemmas and willingness to explore transference material.

Examines one female therapist's countertransference (CTR) reactions during her 1st pregnancy and her willingness to explore certain aspects of the transference. Two clinical vignettes illustrate the ways in which CTR reactions during this pregnancy either facilitated or disrupted the treatment process. In the 1st clinical example, the timing and effect of the therapist's pregnancy on a 30-yr-old female patient stimulated in the therapist feelings of narcissistic vulnerability and guilt. In the 2nd vignette, the demanding and intrusive behaviors of a 34-yr-old woman aroused anxiety and ambivalence in the therapist about the physical changes in early pregnancy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Graduate school training in psychology: Its impact upon the development of professional identity.

Synthesizes information from the published literature and suggests a developmental framework for understanding the development of professional identity among psychology trainees. The authors propose that graduate training in psychology may be viewed in terms of a professional infancy. Transformations students go through may be seen to parallel several developmental milestones in the first year of life as outlined by D. W. Winnicott (1965). The training institution is viewed as a holding environment that is responsible for nurturing healthy development. Obstacles that hinder students' growth within this environment are explored, and suggestions for facilitating development of professional identity are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Love in the Countertransference: Controversies and Questions.

The aim of this article is to bring discussion of the analyst's loving feelings toward his or her patients into open professional dialogue. Several controversies are examined: (a) countertransference love versus love in real life; (b) purposeful self-disclosure of the analyst's loving and sexual feelings; and (c) "falling in love" with one's patients. In each of these areas a personal clinical vignette and selective relevant literature are discussed. As befitting the subject matter, the author's writing style is as close as possible to the experience of the analytic couple, with minimal use of technical and abstract language. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The professional culture of the mental health center as a defense against confronting organizational dysfunction: A case study.

Conflicts in the sociotechnical system of mental health institutions may threaten the staff in a variety of ways and arouse unpleasant affects such as anger, anxiety, and guilt, as well as efforts to erect collective defenses against them. The intrapsychically oriented culture of the mental health center may impede recognition of collective responsibility by means of projective mechanisms that locate the perceived threats in the incompetence or malevolence of individuals. Problems raised at a mental health center by the expansion of services are illustrated through a discussion of a conference given by the center and an observation of a supervisory session. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference and the analytic instrument.

The concept of countertransference may have reached a point where it is too broadly defined. This article differentiates the inner states of the analyst, conceptualized as "the analytic instrument," from his or her behavior in the treatment. It further differentiates between behavior that only hampers an analysis because it permits the transference neurosis to remain intact (simply put, bad therapy) and a different kind of behavior (countertransference proper) that has the potential to destroy an analysis because it seriously damages the transference neurosis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference and empathy: The complex relationship between two divergent concepts in counseling.

Examined the relationship of 20 male counselor trainees' empathic ability (the Barret-Lennard Relationship Inventory) to measures of countertransference behavior and countertransference feelings toward 20 undergraduate female clients. It was expected that empathic ability would be negatively related to the manifestation of countertransference behavior, operationalized as the withdrawal of personal involvement, but positively related to self-reports of openness to countertransference feelings. Empathy was found to be negatively related to countertransference behavior with seductive female clients but not with hostile or neutral clients. Counselor empathic ability was positively related to counselor reports of openness to countertransference feelings. Findings suggest, however, that there was a limit to how often countertransference feelings could be experienced in a given counseling session without spilling over into countertransference behavior. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)