Stigma of psychological therapy: Stereotypes, interpersonal reactions, and the self-fulfilling prophecy.

Investigated stereotypes of counseling center clients and examined how these preconceptions influence social interaction. 136 undergraduates, told they were participating in a study of the acquaintance process in social interactions, were randomly assigned to be perceivers or targets. Ss engaged in a brief getting-acquainted conversation. Targets were randomly assigned to conditions in which perceivers were told that their conversational partner, the target, had been recruited either from among students seeking psychological therapy (clients) or from students in introductory psychology courses (nonclients). As was predicted, perceivers rated clients less favorably than they did nonclients before they interacted. Futhermore, consistent with previous research on the self-fulfilling prophecy, judges' ratings of the interactions revealed that perceivers behaved more negatively toward clients than toward nonclients, and clients came to behave in a less socially desirable manner than did nonclients. It is suggested that fear of rejection that makes people reluctant to seek psychological therapy appears to be justified. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Informing clients about the limits to confidentiality, risks, and their rights: Is self-disclosure inhibited?

Investigated the effects of providing varying amounts of detail regarding the limits to confidentiality in a psychotherapy analog. 24 mildly depressed undergraduates (as determined on the Beck Depression Inventory) were offered an interview to explore their depression and were told it would be much like single-session therapy. Before the interview, Ss were randomly assigned to read and sign 1 of 3 consent forms. Little evidence emerged of significant inhibition of disclosure when detailed information was provided; straightforward encouragement for disclosure eliminated the small inhibitory effect. A 2nd study, with 40 Ss, demonstrated the concurrent validity and sensitivity to change of the major dependent variable. The results of the 2 studies are encouraging not only to psychologists concerned about the moral rights of their clients but also to psychologists who have avoided informing clients about the limits to confidentiality, risks of therapy, and clients' rights because they feared it would necessarily discourage disclosure. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-disclosure in a simulated psychiatric interview.

Describes 2 experiments in which a total of 192 undergraduates received 49 items of personal information previously scaled in terms of their intimacy and presented according to the method of constant stimuli. For each item, Ss indicated whether they believed they would have withheld or revealed that information under actual psychiatric interview conditions. Exp. I manipulated the professional role of the interviewer, confidentiality of obtained information, and sex of the interviewee in a 4 * 3 * 2 design. Results indicate that (a) Ss avowedly revealed more personal information to mental health professionals than they would in a control employment interview situation, with no differences between the mental health professionals; (b) informing Ss that the interview was not confidential produced significant information loss from female but not male Ss; and (c) Ss who received no information regarding confidentiality behaved like Ss who were told the information was confidential. In Exp. II, Ss were asked to assume the motivational-attitudinal state of persons either coerced or voluntarily seeking a psychiatric interview because they had violated interpersonal norms. Significant information loss occurred in coerced Ss while confidentiality had no effect on self-disclosure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client anticipations and preferences for confidentiality of records.

116 new clients requesting services during one semester at a medium-sized university counseling center participated in a survey of preferences and anticipations about confidentiality of their client records. The survey asked Ss to rate the amount of information that they preferred and anticipated would be released by the psychotherapist under 13 request scenarios. Generally, Ss preferred less information to be released than they anticipated would be, but differences existed by scenario and recipient. Homogeneous clusters of Ss were identified who expressed unique anticipations and preferences about confidentiality. Some clusters of Ss preferred absolute confidentiality, but other clusters preferred broad release of their information. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The adult client's conception of confidentiality in the therapeutic relationship.

50 outpatient psychotherapy clients, 26 inpatients, and 50 hospital employees completed a 20-item questionnaire concerning 4 areas relevant to privacy in psychotherapy. Scores on general attitudes revealed that Ss significantly valued confidentiality. Inpatients valued confidentiality significantly more than did the outpatient or nonpatient comparison groups. Data suggest that patients were generally unable to differentiate between privacy as an ethical concept and as a legal concept. Responses to casehandling questions revealed a low level of concern about these technical intrusions on privacy. Total scores for outpatients who perceived a violation in confidentiality in either a past or current therapy relationship were significantly lower than for Ss who indicated no history of past or current violations. Implications for client pretherapy preparation are discussed. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual misconduct in psychotherapy: Reactions to a consumer-oriented brochure.

Assessed reactions of Ss to a brochure addressing the topic of sexual intimacy in psychotherapy. 54 psychotherapy clients and 52 licensed psychologists responded favorably to the brochure, with the majority indicating that the brochure should be made available before therapy begins or during the 1st session. Potential clients (120 college students) read either the brochure on sexual misconduct or a control brochure containing general information about psychology. Ss who read the sexual misconduct brochure showed increased ability to understand what is appropriate and inappropriate therapist behavior, see unwanted touch as nontherapeutic, regard a therapist talking a lot about his or her own sex life as inappropriate, view sex in the therapeutic relationship as inappropriate, and intend to behave assertively within the session if their therapist's behavior should make them feel uncomfortable. Ss who read the control brochure showed no such changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists' needs for training in counseling lesbians and gay men.

A survey of 112 therapists' attitudes, knowledge, concerns, and strategies in counseling lesbians and gay men clients revealed a strong need for therapist training. Although Ss showed generally liberal attitudes toward homosexuals, they admitted a lack of knowledge concerning lesbian and gay male lifestyles. Ss' major concerns in counseling gay clients were the maintenance of objectivity, countertransference, and lack of knowledge of homosexuality. It is recommended that training in counseling lesbian/gay clients become a standard feature of accredited training programs in clinical psychology, that competence in counseling lesbian/gay clients become a prerequisite for state licensure, and that the availability of continuing education regarding therapy for lesbian/gay clients continue for practicing clinical psychologists. (62 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Variables related to premature terminations in a university counseling service.

Investigated the influence of sex and experience level of intaker and assigned counselor, sex of client, and administrative variables (length of initial interview, days from intake to assignment, and days from intake to 1st session) on premature terminations of counseling. Ss were 359 students receiving individual therapy at a university counseling center. Administrative variables were the major factors related to premature terminations. Neither client's nor counselor's sex had any effect on terminations, but lower levels of counselor experience were associated with higher numbers of nonreturning clients. The smaller percentage of clients who terminated prematurely in this study compared to previous studies (e.g., D. Epperson, 1981) may have resulted from the different definition of premature terminations used. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counselor hypothesis-testing strategies.

Conducted 2 experiments relevant to the questioning strategies counselors use in testing their hypotheses about clients. In Exp I, 60 undergraduates were asked to select 12 questions from a list of 38 that would be most helpful in getting to know someone. Ss were asked to test a hypothesis that the other person was an extravert or introvert. The questions were categorized by the experimenters as extraverted, introverted, unbiased, or irrelevant. Most Ss selected a strategy that favored unbiased questions over biased ones. In Exp II, 40 Ss played the roles of clients, and 40 advanced doctoral students in counseling or clinical psychology played the roles of counselors. Counselors were advised that they would soon meet with their client to test a hypothesis that the client possessed or lacked self-control. Counselors were instructed to compose 10 questions to ask the client. The actual interviews were then recorded. The frequency with which counselors developed questions that were confirmatory, disconfirmatory, irrelevant, or unbiased in regard to the hypothesis was not influenced by the specific hypothesis. Results of both experiments do not confirm the hypothesis that counselors preferentially seek information to confirm hypotheses about clients. (21 ref) (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)     

Ethical issues for psychology in the postmodernist era: Feminist psychology and multicultural therapy (MCT).

Proposes that postmodernist inquiries regarding power and authority have contributed to the adoption by some psychologists of discursive stances that are fundamentally ethical. Two of the most important schools defined by their employment of an ethical logic are feminist psychology and multicultural therapy, both of which offer "ethico-therapeutic" treatment modalities to clients perceived to be suffering from psychological wounds caused by some kind of power inequity. Essential to the success of such therapy for clients is the demand by psychologists for changes not only from clients, but from the general society. The authors conclude that the continued development of ethical discourses within psychology may help to meet many of the challenges to psychological well-being in the postmodern era. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The client's perspective: Ethical judgments and perceptions of therapist practices.

In response to a questionnaire, 96 adults, both with and without experience as clients in therapy, judged the ethical appropriateness of 60 therapist practices. In addition, those who had been clients indicated whether the practices had occurred in their own therapy. The practices were organized into 6 groups that corresponded to major areas of professional ethics in psychology: confidentiality, dual relationships, informed consent and business practices, competence, sensitivity to differences, and interventions. Clients and nonclients alike showed a general understanding of ethical principles but uncertainty about many specific points. Some uncertainty stemmed from a misunderstanding about the nature, and particularly the risks, of therapy. Practices judged clearly appropriate were not reported to have occurred universally by the clients in the sample, and practices judged clearly inappropriate were reported to have occurred with some, albeit low, frequency. The results are discussed with regard to implications for ethics research and ethical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of client socioeconomic status on selected behaviors, attitudes, and decisions of counselors.

Seven male and 9 female graduate students in counseling psychology were asked to interview an actor and an actress whom they believed to be real clients. To half of the counselors, the players posed as well-to-do individuals, and to half they posed as working class individuals. They briefly mentioned their socioeconomic status at the beginning of the interview and then told the counselor about some of the problems they were experiencing. When the clients were presented as having lower status, a significant correlation coefficient existed between (a) the counselor's self-reported degree of personality similarity to the client and the counselor's self-reported liking for the client, and (b) the counselor's self-reported liking for the client and the counselor's estimate that the client would benefit from long-term counseling. No significant correlation coefficient existed for data collected during high-status interviews. These results suggest that counselors may unconsciously employ a different decision-making process for high- and low-status clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preparatory action and belief in the probable occurrence of future events.

This study was conducted to determine the influence of behaving as if an event will occur on the belief that it will occur. It was hypothesized that such behavior should increase the belief in the likelihood of the event occurring. Ss (volunteer female high school students) were told that ? the Ss who volunteered would have to take an exam, but not whether they were in that group (50% probability). All Ss were required to do some preparatory study; ? were told to memorize the data in preparatory for the exam, ? to only acquaint themselves casually with it. Ss were then asked their assessment of the probability that they were included in the group to be tested. A larger percentage of the group that had to make the greatest effort (memorize vs. acquaint) believed they would have to take the test. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The subject pool.

Ethical principles regarding the research participation of undergraduate students in a required psychology course were formulated, implemented, and evaluated over 3 semesters. Because S participation was in essence voluntary and dependent on the experimenter's decision to solicit certain course sections and because explanation of the research was given to Ss, it was not possible to design studies, draw a random sample, and assign Ss to a treatment condition. Overall, few problems were found. Few students chose not to participate. 71% of Ss felt participation was a valuable learning experience, and this assessment was more likely when an explanation of the experiment had been given to Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient feedback on satisfaction with direct services received at a community mental health center: A partial replication.

At 8–29 mo after termination, 73 former patients at a community mental health center evaluated the services they had received. As in the author's previous study (see record 1982-28825-001), most Ss reported that therapy had been moderately or extremely helpful. The perceived degree of help received was related to perceived therapist interest in the S and to the number of therapy sessions. Most Ss rated the problem that brought them to the mental health center as being very serious, although the largest diagnostic category was "condition not attributable to mental disorder." Most Ss had not sought further treatment and did not feel that they needed it after termination. Ss returning to the center did not evaluate therapy any differently than new patients. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparing therapist and client perspectives on reasons for psychotherapy termination.

Examines the extent of agreement on the reasons for psychotherapy termination given by therapists and their clients. 194 client files in a psychology training clinic were reviewed to obtain reasons for termination cited by therapists in treatment termination reports. Telephone interviews were conducted with 87 of these former clients to determine their perspectives on reasons for termination. Consistent with previous research, there was little concordance among the reasons cited by therapists and by clients regarding clients' decisions to terminate therapy. Of the clients identified by therapists as terminating because of the successful attainment of therapeutic goals, three-quarters reported this reason as important in their termination decision; of those clients reporting termination because of attaining therapeutic goals, only half were identified by therapists as having achieved their goals. Dissatisfaction with therapy and/or the therapist were reported by many clients as important in their termination decisions; such factors were rarely cited by therapists as reasons for termination. Attention to discrepancies between client and therapist expectations of therapy and therapy termination is necessary to reduce the high rate of premature termination in psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)