Therapist self-disclosure.

Studied therapist self-disclosure in 8 cases of brief psychotherapy with anxious/depressed female clients (aged 32–60 yrs) and experienced therapists (aged 34–78 yrs). As predicted, reassuring disclosures were rated as more helpful by clients and therapists and led to higher levels of client experiencing than did challenging disclosures. However, no support was found for the hypothesis that self-involving (present tense) disclosures would be more helpful than self-disclosing (past tense) disclosures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist and client: Two views of the process and outcome of psychotherapy.

At termination of their therapeutic relationships, 8 male and 7 female therapists (aged 26–59 yrs) along with their 38 male and 37 female clients (aged 19–40 yrs) each independently and anonymously completed a questionnaire concerning the process and efficacy of therapy. Unlike previous findings, the clients rated therapeutic outcome more favorably than did their therapists. In addition, each group attributed the change to different aspects of the therapeutic relationship. Both the aspects cited and the ratings differed as a function of the sex of both therapist and client. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychotherapist and one-way intimacy.

Several prominent psychotherapists have asserted that many therapists use their relationships with clients to gratify desires for controlled, "one-way" intimacy in which they are less vulnerable than the clients. The present experiment tested the hypotheses that (1) therapists have higher needs for control and intimacy than the normative population; (2) need for control is negatively related to quantity and quality of family involvement; and (3) therapists categorized as pseudo-intimate have higher need for control than those categorized as intimate. The FIRO-B and assessments of structured interviews by blind raters provided data on 26 male practicing psychotherapists (aged 29–61 yrs) and 28 male doctoral students (aged 24–48 yrs). None of the hypotheses were supported. Therapist and trainee need scores were similar, and both groups had lower needs for inclusion and needs to be influenced by others than are the norm. Roughly two-thirds of the therapists were categorized as intimate and one-third as pseudo-intimate. Results do not support the idea that therapists gratify their neurotic needs through working with clients. Implications for future research and for therapist selection and training are discussed. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of androgyny on the quality of psychotherapeutic relationships.

Tested the hypothesis that androgynous therapists would form more favorable psychotherapy relationships with their clients than masculine or feminine therapists. 52 psychology practicum dyads (therapists aged 26–40 yrs, clients aged 18–30 yrs) were examined in the context of in vivo psychotherapy sessions. The therapists and clients each completed the Bem Sex-Role Inventory—Revised, and clients also completed the Barrett-Lennard Relationship Inventory. Results indicate that androgynous therapists were judged to produce more favorable relationships, regardless of gender. It is suggested that this superior relationship with androgynous therapists may be attributed to their uniqueness in dealing with problem-solving and interpersonal situations and their ability to blend masculine and feminine orientations. They can be assertive, yet supportive; engage in activities both traditionally gender appropriate and non-sex-typed; demonstrate a greater array of personal behavior and emotionality; organize cognitive data in non-gender-related ways; and combine an open, naturalistic interviewing style with directiveness. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reading the transference in adolescent psychotherapy: A comparison of novice and experienced therapists.

Compared how 3 novice and 3 experienced therapists dealt with the therapeutic relationship. I. Z. Hoffman and M. M. Gill's (1988; see also PA, Vol 76:19773) "patient's experience of the relationship with the therapist" method was used to identify adolescent patients' (16–28 yrs old) allusions to the transference. The experienced therapists (>10 yrs of clinical experience) were quite active in responding to the transference allusions (50–61%), whereas the novices (     

Preliminary development of an interaction matrix for observation of client–therapist relationships in play therapy.

Describes the development of the Carmichael Therapist/Client Interaction Matrix (CTCIM) and presents preliminary findings on its use in supervision of therapists and for empirical study of therapist/client interactions. The purpose of the CTCIM is to graphically depict the relationship between the level of therapist's responses and the client's behaviors in therapy. The CTCIM was used to evaluate 32 sessions in a university play therapy laboratory. Five children (aged 6–10 yrs) were paired with 5 therapists. The 5 children represented a wide range of problems from physical abuse survivors to school adjustment difficulties. The 5 graduate student therapists varied from beginning to moderate counseling experience. A positive correlation was found between therapist's responses and client behavioral outcomes in the preliminary study. Based on the finding that the CTCIM met 4 of the 6 dimensions recommended by P. Howe and L. Silvern (1981) in investigating issues important to therapists and clients, it is concluded that the CTCIM demonstrates potential for empirical studies and for supervision of therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does development do the deed?: Clinical experience and epistemological development together account for similarities in therapeutic style.

Introduces the concept of epistemological development as a variable that may bring some clarity to mixed results regarding the relationships among theoretical orientation, clinical experience, and the conception of an ideal therapeutic relationship, and therapeutic style. Data are reported on the relationships among the aforementioned variables for 161 therapists (aged 23–69 yrs) of 6 distinctive theoretical schools. Results suggest not only that orientation is far more responsible than experience for variation of therapeutic styles, but also that differences between more and less experienced therapists only arise when high levels of both experience and epistemological development are present. Results also suggest that a group composed of more experienced and more developed cognitive and psychodynamic therapists was more homogeneous in therapeutic style than the group composed of all other therapists of the same orientations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual attraction to clients: The human therapist and the (sometimes) inhuman training system.

585 Division 42 (Psychologists in Private Practice) members responded to a 17-item questionnaire designed to gather initial information about the attraction therapists feel for their clients. 286 Ss were aged 45 yrs and under, while 299 Ss were aged 46 yrs and over. Results show that 508 Ss were attracted to clients; significantly more males than females reported such an attraction. Younger Ss were significantly more attracted to clients than were the older Ss. 104 Ss (primarily male) had considered sexual involvement, 91 more than once. Approximately 37 Ss had acted out sexually with clients. 488 Ss indicated feeling uncomfortable, guilty, or anxious about their attraction to clients. 55% of Ss indicated that they had received no education or training about sexual attraction to clients. (65 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Similarity between therapists' and clients' locus of control: Implications for therapeutic expectations and outcome.

Investigated the possible influence of locus of control (LOC) similarity between clients and therapists on therapeutic process and outcome with 21 practicing therapists (mean age 42 yrs) and 78 of their current clients (mean age 35 yrs). LOC was measured for both therapists and clients using Rotter's Internal–External Locus of Control Scale. Therapists self-administered questionnaires on their clinical expectations and therapy evaluations at the beginning and end of therapy, respectively. Questionnaires about the clients' characteristics and clinical expectations were administered at the initial stages of therapy, and questionnaires about the client's LOC and therapy evaluations were administered at the end of therapy. Results indicate that initial similarity in LOC between client and therapist significantly influenced clinical expectations, while the posttest similarity between client's and therapist's LOC significantly influenced evaluations of therapy outcome. Pretherapy matches on the LOC variable were insufficient to predict outcome; however, contemporaneous LOC scores appeared to have utility for client's and therapist's expectations and evaluations. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Graduate training in psychotherapy: Are therapy outcomes enhanced?": Comment on Stein and Lambert (1995).

Comments on the article by D. M. Stein and M. J. Lambert (Journal of Consulting & Clinical Psychology, 1995[Apr], Vol 63[2], 182–296). The authors misunderstood the meta-analysis of P. Crits-Cristoph et al (see record 1992-20595-001) as examining the relation of therapist experience to "therapist effects" (i.e., differences between therapists in their average outcomes). The Crits-Cristoph et al results did not show that experienced therapists had better outcomes than less experienced therapists. It is also noted that the data in Table 3 are, in fact, correct. However, these 2 errors do not affect the main findings of Stein and Lambert's article. (The following abstract of this article originally appeared in PA, Vol 82:26915.) Several sources of indirect evidence supporting the value of graduate training in psychotherapy are reviewed here. Training protocols that are known to enhance trainees' skills are briefly discussed, as are conclusions of meta-analytic reviews examining relationships between therapist experience and training, and therapy outcome. An updated meta-analysis of therapy outcome studies involving within-study comparisons of psychotherapists of different levels of training and experience is summarized.… (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual and business relationships between therapists and former clients.

Examined the incidence of post-termination sexual (PTSRs) and business relationships (PTBRs) between therapists and former clients, as well as the legal, clinical, demographic, and professional judgment considerations related to both PTSRs and PTBRs. Among a sample of 348 therapists (aged 29–81 yrs; 52% male) who had been delivering psychotherapy services for an average of 14 yrs, it was found that 6.5% engaged in PTSRs and 29% engaged in PTBRs. Demographic comparisons showed that males were significantly more likely to engage in both PTSRs and PTBRs. PTSRs were always viewed as more inappropriate than PTBRs. Results provide considerable support for the inclusion of prohibitions against sexual intimacies with former clients as part of the Ethical Principles and Code of Conduct (American Psychological Association; see record 1993-19413-001). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of locus of control on counseling expectations of clients.

Investigated the relation between clients' locus of control and expectations of therapeutic outcome among 67 clients (mean age 29 yrs) with mild neurotic problems. Clients were asked to estimate their likely success with therapists presented in a series of videotaped role plays. The role plays depicted the locus of control, sex, and social class of therapists. Results indicate that there was a significant interaction between clients' and therapists' locus of control in relation to clients' judgment of clinical success: Internal clients anticipated greater success with internal therapists, and external clients expected greater success with external therapists. Implications for the counseling process are discussed. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived influence of life experiences on clinical psychologists' selection and development of theoretical orientations.

Investigated the types of life experiences perceived by 31 male and 9 female behavioral and psychodynamic (PD) psychologists as influential in the development of their theoretical orientation. Half of the Ss were experienced therapists (aged 31–59 yrs); the other half were clinical psychology graduate students. Ss completed a theoretical orientation survey and a checklist of variables influencing the selection of a theoretical orientation and were also interviewed individually. Results show that therapists in the PD group (1) reported significantly more mental illness in members of their families of origin, (2) offered significantly more personal as opposed to professional reasons for seeking therapy, (3) reported significantly more conflict within their families of origin when compared with therapists in the behavioral group, and (4) reported seeking personal therapy more often (95%) than therapists in the behavioral group (40%). Implications for training of therapists are discussed. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A model for teaching and evaluating brief psychotherapy with children and their families.

A pilot study with 5 children (aged 7–22 yrs) and 5 therapists with 1–3 yrs of supervised clinical experience demonstrated the feasibility of teaching a method of planned time-limited therapy with children and their families to relatively inexperienced therapists in a clinical setting. Significant features of the therapy, which consisted of 10–22 sessions over a 16-wk period, included a focus on client-suggested goals; an emphasis on skills deficits rather than pathology; and some techniques from structural family therapy and from educational, behavioral, and cognitive interventions. Reasons for the success of the present therapy method are considered. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapists' assessments of their development at different career levels.

Experiences of current and career professional development were surveyed for 3,958 psychotherapists at all career stages in several western countries. Participants included psychologists, psychiatrists, and other mental health practitioners representing a broad range of theoretical orientations. The mean number of years in practice for the participants was 11.2, with a range of less than 1 to as many as 52. The Ss were aged 22–90 yrs. Measures of experienced development were consistent across professional and demographic categories. As expected, perceived therapeutic mastery increased with increasing years in practice, but currently experienced growth remained at a high and unexpectedly constant level across career cohorts, including the most senior practitioners. Overall findings suggest that therapists experience development simultaneously as a gradually increasing sense of professional expertise and as an ongoing sense of continual improvement, interpreted as essential to maintaining their motivation and morale. Contributions of these aspects of therapist development to process and outcome are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist differences in cognitive–behavioral psychotherapy for generalized anxiety disorder: A pilot study.

Little is known about factors differentiating more and less effective therapists or the mechanisms through which therapists influence outcome. In the present study, the performance of a small sample of 4 therapists was compared in the context of delivering cognitive–behavioral psychotherapy (CBT) to 32 clients with generalized anxiety disorder. More effective therapists were characterized by higher observer-rated CBT competence, higher client outcome expectations and client treatment credibility assessments, and higher early treatment client ratings of therapeutic alliance quality. Higher early CBT competence was associated with higher client midtreatment outcome expectations, which in turn were associated with better posttreatment outcomes. Although these findings are preliminary given the small sample of therapists and clients, they suggest that the common factor of outcome expectations might be a mechanism through which the specific factor of psychotherapist competence exerts its influence on treatment outcome. The implications of these findings and directions for future research are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Therapist participation in metaphor generation: Collaborative and noncollaborative styles.

Examined how therapists and clients construct, express, and apprehend metaphors. Five client-generated and 6 therapist-generated metaphors were selected across 4 therapy dyads, with 1 therapy session being focused on in each dyad. The clients had been in therapy for 12 sessions, and the therapists had 5–20 yrs of experience. Each S's and therapist's recollections of the metaphoric events were stimulated by audiotape playback within 24 hrs of the therapy session. Participants' recollections included thoughts and feelings that had been kept private in the therapy session. A qualitative analysis of the participants' accounts revealed that each dyad entailed 1 of 2 distinct patterns of metaphoric communication. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients' pretherapy interpersonal attitudes and psychotherapy outcome.

Investigated whether 55 outpatient counseling clients' (aged 16–57 yrs) pretherapy scores on affiliation–hostility and dominance–submission dimensions of the Interpersonal Check List (ICL) would be related to outcome of therapy. Ss, who received an average of 24 sessions, completed the ICL both pre- and posttherapy. Ss whose therapy was successful, as rated by both therapist and client, were significantly more affiliative (less hostile) than were less-than-successful therapy clients both pre- and posttherapy. 21 of 29 Ss whose predominant pretherapy interpersonal stance was characterized as affiliative had successful outcomes, whereas only 10 of 26 Ss whose predominant pretherapy interpersonal stance was characterized as hostile had successful outcomes. No significant differences were observed between outcome groups on the dominance–submission dimension either pre- or posttherapy. However, as expected, a significant number of successful therapy Ss showed a pre- vs posttherapy shift in their interpersonal stances from submission to dominance. Results highlight the reported difficulty of short-term dynamic psychotherapy with hostile clients and suggest the importance of assessing clients' pretherapy interpersonal attitudes as 1 influence on therapeutic process and outcome. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)