First pregnancy: Therapeutic issues for both female and male psychotherapists.

Discusses the reactions of psychotherapy clients to their therapist's 1st pregnancy, including the stimulation of unresolved oedipal and early developmental conflicts, fear of rejection and abandonment, and separation anxiety. Intensification of a maternal transference, sexual identity issues, and maternal loss and deprivation issues, along with hostile fantasies toward the unborn child and envy of the therapist as a mother and a sexual and fertile person, may arise. The reactions of the female therapist to her pregnancy may include emotional changes related to hormonal fluctuations, fatigue, and a growing sense of physical vulnerability; distraction due to the kicking of the fetus; and reduced functioning as a therapist due to feelings of fear, anger, guilt, and confusion over leaving her patients. Despite the paucity of research into the impact of impending parenthood on male therapists, it is suggested that they may experience many of the same role changes and conflicts, emotions, and reactions experienced by female therapists. Two case vignettes are presented to illustrate patient and therapist reactions to pregnancy, and suggestions to help both therapists and clients prepare to deal with issues surrounding the pregnancy are offered. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An analog study with beginning therapists suggesting bias against "activity" in women.

Investigated the effects of client sex and therapist attitudes toward women on treatment planning for an "active" client by having 28 social workers, 28 psychiatrists, 2 nurses, and 3 psychologists (aged 20–30 yrs) formulate a treatment plan for either a male or female client whose cases were identical except for client sex. The client was portrayed as active in work, sex, and interpersonal relationships. Results show bias against activity in women: The female client was seen as having an intrapsychic problem requiring individual insight-oriented therapy, while the male client, with the same presenting problem of marital conflict, was seen as having an interpersonal relationship problem requiring couples' therapy. Activity in a woman was viewed as neurotic. The conflict was conceptualized as unresolved issues about sexual identification, implying normal femininity had not been achieved. Therapists expected that the woman would make the concessions in the relationship and would compromise her career ambitions to achieve a more satisfactory balance of the roles of career woman and wife. It is suggested that therapists must reexamine their conceptualization of activity in men and women and the consequences of their beliefs in everyday clinical practice. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender and representation in psychotherapy.

Investigated the ways in which patient and therapist gender influence the nature of patients' internalized representations of their therapist and the therapeutic relationship. A sample of 66 patients (29 males) completed the Therapist Representation Inventory (J. D. Geller et al, 1982), a self-report instrument designed to assess discrete properties of evoked representations. Results indicated widespread similarities between male and female patients in terms of the forms with which representations are evoked and the themes embodied in these representations. The differences that emerged suggest that women are more likely to keep their therapists in mind (and for longer periods of time) when working on their problems outside of therapy and that women with male therapists are especially likely to daydream about therapy and acknowledge missing their therapist in between sessions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist retrospective recall impasses in long-term psychotherapy: A qualitative analysis.

Twelve experienced therapists completed a questionnaire, and 8 of the 12 were then interviewed about their experiences with a therapeutic impasse that ended in the termination of therapy. Data were analyzed using a qualitative methodology. Results indicated that most of the clients were anxious and depressed with personality disorders and interpersonal problems. Therapists perceived impasses as having a profound negative impact on both clients and therapists. Variables associated with impasses in a majority of the cases were a client history of interpersonal problems, a lack of agreement between therapists and clients about the tasks and goals of therapy, interference in the therapy by others, transference, possible therapist mistakes, and therapist personal issues. Implications for training, practice, and research are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Importance of having a female cotherapist in a child molesters' group.

Including a female cotherapist in a group of child molesters can assist in generating valuable transference issues, as well as modeling appropriate social interactions between men and women. The benefits and frustrations of being a female cotherapist in a group of child molesters are examined. The significance of the interaction between the male and female cotherapists is discussed. Case examples are used to illustrate these points. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of Strupp's and Jenkins's audiovisual psychotherapy analogues and real psychotherapy interviews.

31 therapists participated in 2 analog interviews, one involving responses to a film of a male client and the other of a female client. In addition, each therapist was asked to audiotape-record 2 real initial intake sessions, 1 with a male client and 1 with a female client. The audiotapes of the therapists' verbal responses in the real and analog interviews were rated along 4 process dimensions—accurate empathy, ambiguity, self-disclosure, and therapist commitment. Results indicate that the analogs were poor predictors of real therapy behavior. Additional findings are also discussed. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A study of the dilemmas involved in work with schizophrenic patients.

Discusses some of the difficulties involved in transference and its handling with schizophrenic patients, using the treatment of a 22-yr-old chronic schizophrenic male as an illustration. Two major findings have emerged since Freud's contention that the schizophrenic could not form a transference relationship: The schizophrenic can form a transference relationship to the therapist, although (1) it may be of a different kind than that of the neurotic, and (2) for some therapists it is no longer the major tool of therapy. As the nature of the relationship changes from that of one whole person relating to another to that of a mother relating to a child, there is a shift in therapeutic technique. Whereas, in the former relationship, interpretation of the transference is primary, in the latter, the context or the setting for that interpretation becomes primary. The therapist must create a safe environment for schizophrenics as they regress to dependence. The therapist must be willing and able to merge with the patient, to be mother to the infant patient. This stance requires the utmost from the therapist, and thus countertransference acquires major importance in this work. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between clients' perceptions of therapist–parent similarity with respect to empathy, regard, and unconditionality and therapists' rating of client transference.

The authors studied the similarity between clients' perceptions of their therapists and their perceptions of their parents (or early parental figures) in terms of the relationship qualities of empathy, positive regard, and unconditionality of regard and how those perceptions compared with their therapists' ratings of transference. Participants were 62 actual therapy dyads. The results failed to support a hypothesized positive association between the similarity of the therapist and parents or parental figures on the relationship dimensions of empathy, regard, and unconditionality and therapist ratings of transference. Instead, the clients' relationship ratings of their parents and therapists suggested that therapists' perceptions of transference may more accurately reflect perceptions of their clients' nontransferential (i.e., real relationship) reactions to the therapist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-concept and self-esteem as moderators of client transference.

Operationalized transference as (a) the similarity of clients' perceptions of their therapist and their perceptions of their parents and (b) therapists' ratings on a transference scale, Therapy Session Check Sheet (TSCS; H. Graff and L. Luborsky, 1977), and examined the moderating role of self-esteem and ego development on client transference. Ss were 62 clients (aged 19–63 yrs) who were already involved in therapy, and 29 therapists (aged 25–61 yrs). The Barrett-Lennard Relationship Inventory (G. T. Barrett Lennard, 1962, 1973) measured the facilitative conditions (regard, empathy, and unconditionality) and therapist–parent similarity and the TSCS measured the therapists' perceptions of transference. Additional measures were the Ego Identity Scale (A. L. Tan, et al, 1977) and the Rosenberg Self-Esteem Scale (M. Rosenberg, 1979). Results support the idea that self-esteem and ego development impact a client's view of the therapist and parental figures and are associated with therapists' views of transference. Persons with low ego identity and low self-esteem tended to see their therapists and parental figures more dissimilarly; and the more transference that a therapist perceived, the greater the tendency for the client to have low ego identity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some gender effects in a brief psychotherapy.

Two studies investigated the influence of therapist gender as well as patient age and pretreatment distress level on process and outcome in a brief 12-session psychodynamic psychotherapy. Pre- and posttherapy assessments disclosed that patients treated by female therapists experienced more symptomatic improvement and reported more satisfaction with treatment than those treated by male therapists. However, patient age accounted for twice, and patient pretreatment level of disturbance more than three times, the outcome variance contributed by gender. In Study 2 female therapists were judged to arouse less negative affect in women patients and to arouse fewer interpersonal difficulties. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Women therapists working with women: New theory and process of feminist therapy.

Reviews the book, Women therapists working with women: New theory and process of feminist therapy edited by Clair M. Brody (1984). As with other edited volumes on this topic, this book attempts to address a very broad range of issues confronted by a therapist holding a feminist theoretical perspective in her work. Where this is most original and successful is in the examination of the issues faced by the therapist as a woman and feminist in the social and emotional environment of therapy. This volume does not stand alone as a text on feminist therapy, and that was clearly not the editor's intention. It will probably be of most interest and use to therapists already familiar with other literature on feminist therapy, and serves to complement what has come before. I would not suggest it as any reader's first introduction to feminist therapy theory and practice. However, it is sufficiently introductory that it can be of use to any experienced psychotherapist seeking to enhance her or his consciousness of women's issues and sexism as they impact upon the process of psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist sexual orientation, gender, and counseling practices as they relate to ratings on helpfulness by gay and lesbian clients.

Three hundred ninety-two lesbian and gay volunteers described their experiences with 923 therapists, reporting therapist sexual orientation, therapist gender, and perceived helpfulness of the therapist in each case. Gay, lesbian, and bisexual therapists of both genders and heterosexual female therapists were all rated more helpful than heterosexual male therapists. Participants also reported whether each therapist exhibited 9 negative and 4 positive practices. Relative risk ratios indicated that 8 of the 9 negative therapist practices were significantly associated with (a) client designation of a therapist as unhelpful and (b) termination after 1 session. All 4 of the positive practices were inversely associated both with unhelpful ratings and with termination after 1 session. Therapist practices accounted for more of the variance in ratings of helpfulness than did therapist demographic characteristics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Getting the picture: The use of imagery to clarify therapeutic impasses.

Contends that imagery can be used to disclose the nature of the client–therapist relationship and to resolve therapeutic impasses. The most common forms of impasses in the relationship are the result of therapist's misperceptions, the pacing of therapy dealing with acting-out behavior, difficulties induced by transference and countertransference, and difficulties in making alliances with severely disturbed patients. To uncover latent images in the therapist–client interaction, therapists imagine a metaphoric meeting place with a client, what they become to each other there or what other forms they take, the activity both might be engaged in, what a dance between the 2 might look like, what might be done differently, and what translations can be made from the imaginal to the actual therapeutic relationship. Case illustrations with 4 female and 2 male clients are given. It is suggested that images clarify the symbolic and affective elements of the internal world. (45 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What is implied?

Argues that G. Stricker (see record 1977-29882-001), in his article on research implications for psychotherapy with women, cannot dismiss the analog data of others while using different analog studies to support his own statements. Stricker's conclusions concerning the frequency of sex between therapist and client and the bias of male vs female therapists are based only on his own speculations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dreams about the therapist: Mood, interactions, and themes.

Analyzed the mood, interactions, and themes in the manifest dream representations reported by 67 25–71 yr old psychotherapist volunteers, who each reported 1 dream about his/her own therapist. Ss tended to have unpleasant dreams featuring therapists who were frustrating or gratifying. In the dreams, friendly, aggressive, and sexual interactions were initiated by therapists; only the friendly interactions tended to be reciprocated. Four overarching themes emerged: separation-rejection, seduction-antagonism, protectiveness-responsiveness, and praise. It is proposed that these characteristic ways of dreaming about the therapist depict issues of central importance for many patients, and reflect patients' effective use of the transference to work on their concerns. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client attachment to therapist: Relations to transference and client recollections of parental caregiving.

This study examined the relations between client attachment to the therapist and therapist perceptions of transference, as well as between client attachment and recollections of parental caregiving. Participants were 51 client-therapist pairs in ongoing therapy. After a therapy session, clients completed a measure of their attachment to their therapists and a measure of their perceptions of parental caregiving during childhood. Therapists rated levels of positive and negative, and amount of, client transference. Both secure and preoccupied-merger attachment were positively related to both negative transference and amount of transference. Level of avoidant-fearful attachment was not correlated with any type of transference. Insecure attachment to the therapist was associated with more negative recollections of parental caregiving. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Should men treat couples? Transference, countertransference, and sociopolitical considerations.

Describes couples therapy (CPT) as both a conversation and an experience which are significantly different for each member of the couple when the therapist is a male. CPT differs profoundly from individual therapy in that CPT involves 3 people, 2 of whom will share the same gender, resulting in an inherent imbalance with important transference and countertransference consequences and dilemmas. This imbalance and the transference–countertransference constellations that result are explored. Recommendations concerning gender sensitivity are made to the therapist to promote appropriate treatment. The author believes that if asked whether men should treat couples, the simple answer should be yes, because men are clearly capable of treating couples. The more complex answer is yes, but only with great sensitivity to gender issues, within the couple itself, and within the therapist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Study of variables related to client engagement using practicum trainees and experienced clinicians.

Examined the relationship between (1) therapist understanding of, preparation for, and education of clients, and duration of initial interview and (2) engagement of clients for more than 1 session. Questionnaires were given to 2 male and 2 female psychotherapy practicum trainees, 2 male and 3 female experienced psychologists, and their 238 clients (84 male and 154 female college students). Engagement interviews were significantly longer and more instructive than nonengagement interviews. Female therapists were rated as equally understanding by clients of both genders, but male therapists were rated as less understanding by female clients. Professional females were the highest engaging therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex bias in psychotherapy: An examination of the effects of client sex, pathology, and therapist sex on treatment planning.

Investigated the effects of therapist sex, client sex, and client pathology on treatment goals formulated by a pool of 32 male and 32 female practicing psychotherapists (psychiatrists, clinical psychologists, psychiatric social workers, and therapists from related disciplines). Each therapist recommended treatment goals for either 2 male or 2 female pseudoclients who differed in their presenting pathology, which was severe and clearly defined. Male therapists chose significantly more feminine treatment goals for all their clients, whereas female therapists chose significantly more masculine goals, regardless of client sex. Therapists responded to the client's pathology, rather than the client's sex, in formulating treatment goals. This suggested either that client sex is not important in determining treatment goals or that client sex may affect therapists' treatment goal choice only when pathology is vague or not severe. (PsycINFO Database Record (c) 2010 APA, all rights reserved)