Good and poor practices in psychotherapy: National survey of beliefs of psychologists.

As part of a larger study of behaviors and standards of psychologists and resources for guiding their actions, survey data were collected from 456 (231 male and 225 female) American Psychological Association members selected from Division 29 (Psychotherapy). Participants were asked to rate the degree to which they considered each of 83 behaviors to constitute good or poor practice. About one fourth (22) of the behaviors were considered to be uniformly "poor" by at least 60% of the participants. Only 2 behaviors were judged uniformly "good" by at least 50% of the participants. About one fourth (18) of the behaviors were difficult to judge (i.e., at least 20% of the participants indicated "don't know/not sure"). Participants tended to report that their behavior conformed to their standards of good practice and had a tendency to maintain stricter standards for judging whether a behavior was good or poor practice than for judging whether it was ethical or unethical. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients', therapists', and judges' evaluations of psychotherapy.

Asked 41 patients and their 17 therapists to complete a questionnaire indicating problem areas and their severity before and after the 1st and last therapy session. 2 clinical psychologists served as independent judges rating the client questionnaires. The clients' evaluations were unrelated to their therapists' evaluations, but were highly related to the evaluations made by independent judges. Further analyses suggest that the disagreements between clients and therapists stemmed from the therapists' inaccuracy in perceiving the clients' problems and the therapists' tendency to overestimate the progress of therapy relative to clients and independent judges. The results and the broader issue of client-therapist disagreements are discussed in terms of the client as a "consumer." (l6 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Informed consent: Therapists' beliefs and practices.

To assess the current status of informed consent among psychotherapists, a survey instrument was sent to 324 American Psychological Association members currently practicing therapy. 189 therapists returned completed surveys, yielding a response rate of 58%. Survey responses provided information on use, importance, reasons, communication, methods, and timing regarding 5 specific consent issues. These issues included confidentiality, risks, treatment length, treatment procedures, and alternatives. Results suggest similarity and variability in therapists' reported beliefs and practices. Therapists of a cognitive-behavioral orientation indicated they inform clients more often and consider the issues more important. These findings, along with the reasons given for not informing clients, highlight the complexity of applying ethical standards to practice contexts. Implications for practice and research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contingency and control beliefs as predictors of psychotherapy outcomes among children and adolescents.

Suggests that control-related beliefs may predict problem-solving behavior in psychotherapy if 2 conditions are met. First, distinction must be made among beliefs about outcome contingency, personal competence, and control (defined as the capacity to cause intended outcomes). Second, beliefs must be assessed for the specific behavioral domain that is the object of prediction (rather than global locus of control). This was tested among 78 8–17 yr olds referred for outpatient therapy. At the outset, Ss answered probes assessing contingency, competence, and control beliefs about solving problems at home and at school. At the outset and again 6 mo later when therapy had ended, parents reported the Ss' problems at home and at school, using the Child Behavior Checklist. Perceived contingency and perceived control accounted for 29% of the variance in total problem reduction, indicating that the 2 beliefs were related to problem solving during therapy. This suggests that the effects of child psychotherapy may be enhanced by targeting children's contingency and control beliefs for intervention. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The accuracy of therapists' interpretations and the outcome of dynamic psychotherapy.

This study developed a measure of the accuracy of therapists' interpretations based on the core conflictual relationship theme method and examined the relation of accuracy to the outcome of dynamic psychotherapy. Accuracy was assessed on therapists' interpretations from two early-in-treatment sessions of 43 patients receiving moderate-length dynamic therapy. The results indicated that accuracy about the main wishes and responses from others that were expressed in the relationship themes was significantly related to outcome, even after the effects of general errors in treatment techniques and the quality of the helping alliance had been controlled for. Our hypothesis that accurate interpretations would have their greatest impact in the context of a positive helping alliance was not confirmed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A qualitative investigation of eminent therapists' values within psychotherapy: Developing integrative principles for moment-to-moment psychotherapy practice.

Ample empirical research on values has demonstrated that clients' values tend to become increasingly like those of their therapist during therapy. There is little research, however, on how therapists negotiate value conflicts and the role of values in therapy. In order to better understand this process, 14 expert psychotherapists from four major psychotherapy orientations were interviewed about their use of values in the psychotherapeutic change process. A grounded theory analysis was conducted leading to an integrative understanding of how expert therapists from different orientations conceptualize the relationship of values and change in therapy and how they work with values in sessions. Based on this analysis, four transtheoretical principles were generated that can be applied to training and practice and used to inform research on psychotherapy process and integration. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Routine inquiry into sexual victimization: A survey of therapists' practices.

Surveyed therapists regarding their practices in assessing clients' sexual abuse history. Of the 105 respondents, 51% reported that they routinely ask all clients or most clients about sexual abuse at some time during the course of therapy; 19% reported that they had asked only a few clients or that they never ask clients directly about sexual abuse. Therapists who were younger, who had been in practice for a shorter period of time, and whose current caseload included a high percentage of sexually abused women were most likely to have asked all or most of their clients about having been sexually abused. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Knowledge and beliefs about confidentiality in psychotherapy.

Surveyed 200 high school students, 308 undergraduate psychology students, 34 former clients from a community mental health center, and 40 former clients from a university counseling center regarding their knowledge of and attitudes toward confidentiality in therapy. Overall results show that the vast majority of Ss viewed confidentiality as an all-encompassing, superordinate mandate for the psychology profession and that most Ss wanted to be told of the limitations to confidentiality but would have limited therapeutic communications when told. It is concluded that the general population, including those who have been in therapy, does not have an accurate perception of current ethical limitations regarding confidentiality in psychotherapy. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Values in psychotherapy: A survey of practitioners' beliefs.

Investigated whether psychotherapists believe their values influence treatment and, if so, how they should be communicated to the patient. Questionnaires completed by 319 experienced psychotherapists (average age 43.9 yrs) indicated that 89% agreed that values of the therapist have a direct influence on therapy. 43% agreed and 37% disagreed that the therapist's values should influence therapy, with behaviorally and humanistically oriented Ss more likely to agree than psychoanalytically oriented Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exercise and diet therapy: Psychotherapists' beliefs and practices.

Two hundred thirty-two members of Division 29 of the American Psychological Association (46.4% of those randomly sampled) responded to a survey concerning their assessment and recommendation practices relating to nutrition and to exercise and physical fitness. Respondents reported assessing and recommending diet and exercise practices less frequently than other health behaviors, but many indicated conditions amenable to exercise and diet recommendations. Few therapists had received education in exercise and nutrition, but more than half believed that diet and exercise should be required as a component of the graduate school curriculum. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The future of psychotherapy with children: Developmental psychotherapy.

Discusses the concept of developmental psychotherapy for children as a way of integrating information about human development, basic biological processes, and psychopathology with knowledge gained from studies of therapeutic change. In developmental psychotherapy, rather than trying to provide a permanent cure, the therapist tries using a variety of methods to help the child regain a footing on a developmental pathway more likely to lead to adequate adaptation in subsequent periods of life. Research in this field should concentrate on continuing refinement of models for developmental pathways leading to specific outcomes in a number of domains, particularly those involving externalizing disorders and substance abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How religious beliefs affect psychotherapy: The example of Mormonism.

Following a discussion of the need for psychotherapists to understand the religious beliefs of Mormon clients, the historical development and social milieu of Mormonism is described. Selected beliefs and their psychotherapeutic consequences are discussed, including potency of religion, relationship to God, sexuality, grace and works, and the Mormon lifestyle. These beliefs and consequences are illustrated through the case of a woman in therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

African American and European American therapists' experiences of addressing race in cross-racial psychotherapy dyads.

Using Consensual Qualitative Research, 12 licensed psychologists' overall experiences addressing race in psychotherapy were investigated, as were their experiences addressing race in a specific cross-racial therapy dyad. Results indicated that only African American psychologists reported routinely addressing race with clients of color or when race was part of a client's presenting concern. European American psychologists indicated that they would address race if clients raised the topic, and some reported that they did not normally address race with racially different clients. When discussing a specific cross-racial dyad, African American therapists more often than European American therapists addressed race because they perceived client discomfort. Only European American therapists reported feeling uncomfortable addressing race, but therapists of both races perceived that such discussions had positive effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recovered memories of childhood sexual abuse: Clinicians' practices and beliefs.

The issue of recovered memories of childhood sexual abuse (CSA) has stirred up a great deal of controversy in the field of psychology and in the public media. Recent court trials and television specials suggest that recovered and false memory cases occur often. Clinicians completed a survey designed to determine the prevalence of recovered memories for CSA in their clinical practices and to assess whether the recovered memory controversy had affected their treatment of female CSA victims. Despite the publicity the debate over memories of CSA has attracted, few cases of so-called recovered memory were reported. Even fewer cases of so-called false memory were reported. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving psychotherapy: Old beliefs, new research, and future directions.

Refutes common beliefs that deter efforts to measure and improve psychotherapy's effectiveness and to reduce its costs, asserting that (1) therapy outcomes and costs may in some cases be inversely related, (2) therapists should examine cost-effectiveness, (3) psychotherapeutic effectiveness can be quantified, and (4) laboratory research is not the only way to improve therapy. The authors propose a revitalized scientist–practitioner model, expanded research methodologies, and implementation of alternative incentive or service delivery mechanisms as steps toward obtaining better therapeutic outcomes from available dollars. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Change in irrational beliefs and the outcome of rational-emotive psychotherapy.

The rational-emotive (RE) model posits that changes in the endorsement of irrational beliefs mediate the therapeutic effects of RE psychotherapy. The present study examined the correlations between pre- to post-treatment changes in beliefs and changes in treatment-outcome measures within the context of a previously published study of RE therapy (M. Lipsky et al; see record 1980-23637-001). Ss were 50 adults assigned to 1 of 5 conditions (RE therapy, RE therapy plus rational role reversal, RE therapy plus RE imagery, alternative treatment, or control), who completed an idea inventory and measures of anxiety, depression, and neuroticism. As predicted, reliable correlations between changes in beliefs and changes in emotional distress were obtained. This relationship occurred in control conditions as well as in treatment groups, qualifying the support obtained for the RE model. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identifying and integrating helpful and harmful religious beliefs into psychotherapy.

The 2 main roles of the psychotherapist involve identifying and understanding the client's problems/strengths and treating problems. Suggestions are offered to guide addressing or avoiding religious beliefs in both roles. Types of religious beliefs that contribute to distress, particularly for youth, are identified and treatment options are offered. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Values, beliefs, religion and the persuasive influence of psychotherapy.

Psychotherapy has been conceptualized as a process of interpersonal persuasion. An often unrecognized implication of such an assumption is that the therapist's values and beliefs are transmitted to patients during the course of successful treatment. A review of available literature provides sufficient reason to believe that patients' values, attitudes, and beliefs change in psychotherapy and that to some degree these changes are associated with the degree to which therapy is successful. Research evidence suggests that patients acquire the specific values and attitudes of their own therapists rather than simply a more mature or adaptive set of beliefs. There appears to be some similarity between those parameters that affect therapeutic gain and those that affect persuasion in the social psychology laboratory. Such positive findings from the literature underline the importance of therapists taking cognizance of their own personal values as determiners of therapeutic gain. The findings highlight the necessity of research designed to investigate the role of specific values in this process. (78 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)