Clients' assimilation of experiences of their therapists.

In this study, we examined how clients internalize their therapists, understanding this phenomenon through the lens of the assimilation model, a theory of psychological change. The assimilation model describes people as comprised of multiple voices, each voice being a representation of interrelated experiences organized around significant people or events. In this study, we interviewed five former psychotherapy clients and asked them to describe how they experienced, and continue to experience, their therapists internally. On the basis of these interviews, we extended the assimilation model by constructing an account of how clients’ experiences of their therapists are internalized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients' perceptions of therapists with high attrition rates.

59 adult clients assigned to high-dropout rate therapists and 51 assigned to low-dropout rate therapists rated the therapists on several demographic and therapy-process variables. Findings show that a number of the therapy-process variables significantly differentiated the 2 groups of therapists. It is advocated that researchers consider the role of the therapist and therapy-process dimensions in future studies of early psychotherapy termination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients' perceptions of their psychotherapists' multicultural orientation.

The current retrospective study examined whether clients' (N = 176) perceptions of their psychotherapists' multicultural orientation (MCO) were associated with their psychological functioning, working alliance, and real relationship scores. Moreover, we tested whether clients' perceptions of the working alliance and the real relationship mediated the relationship between clients' perceptions of their psychotherapists' MCO and psychological functioning. The results showed that clients' perceptions of their psychotherapists' MCO were positively related to working alliance, real relationship, and psychological functioning. Only clients' ratings of the working alliance mediated the relationship between clients' perceptions of their psychotherapists' MCO and psychological functioning. Thus, because clients perceive their psychotherapists as being more oriented toward cultural issues, they may view the therapist as being more credible and may gain a sense of comfort in the therapeutic process. In turn, clients' strong alliance facilitates improvement in psychological well-being. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Incidental encounters between therapists and their clients.

Data about incidental encounters with clients in public settings were provided by 573 college therapists (return rate?=?32%), using J. C. Flanagan's (1954) critical incident technique. Results indicated that many therapists experience feelings of surprise, uncertainty, and discomfort, as well as concern about possible violation of confidentiality and therapeutic boundaries during such encounters. Implications for future research are discussed in light of these findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How patients coach their therapists in psychotherapy.

Examines coaching behavior in the therapeutic relationship from the perspective of control mastery theory. The expanded concept of coaching presented here views the patient as actively engaged throughout therapy in prompting, instructing, and educating the therapist to relevant aspects of the patient's plan for disconfirming pathogenic beliefs and attaining treatment goals. Three therapy situations encountered when coaching is prominent are identified and illustrated with clinical vignettes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients' perceptions and evaluations of similarities to and differences from their counselors.

Forty-seven community mental health clients were asked in an open-ended format to describe the ways in which they were similar to and different from their counselors; rate how significantly these similarities and differences affected the counseling relationship; and categorize the type of effect on the counseling relationship as being either good, bad, or neutral. Results revealed that personality traits were most frequently cited as similarities. Demographic variables and personality traits were most frequently cited as differences. Both similarities and differences were rated as having primarily positive effects on the counseling relationship, with similarities having a stronger perceived impact on the relationship than differences. Methodological considerations for exploring personality-trait and demographic similarities and differences between counselors and clients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ambiguity tolerance of therapists and process changes of their clients.

Investigated the relationships between 18 student-therapists' tolerance for ambiguity in visual perception tasks and (a) the positive affect displayed toward them by their 22 student clients, (b) changes in proportions of clients' self-reference statements, and (c) measures of improvement in clients' "adjustment." Results show an increase in clients' positive affect toward the therapists but no relationship between changes in clients' affect toward their therapists or the number of their self-reference statements and the therapists' tolerance for ambiguity. Clients of ambiguity-tolerant therapists described themselves more negatively, but all but 2 clients described themselves more favorably later in therapy. No positive correlation was obtained between client and therapist affect toward each other. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients' deference in psychotherapy.

14 psychotherapy clients were interviewed about their recollections, assisted by tape replay, of an immediately preceding therapy session. A major category derived from a grounded theory analysis of the interview protocols was client's deference to the therapist, constituted of 8 lower level categories: concern about the therapist's approach, fear of criticizing the therapist, understanding the therapist's frame of reference, meeting the perceived expectations of the therapist, accepting the therapist's limitations, client's metacommunication, threatening the therapist's self-esteem, and indebtedness to the therapist. The P. Brown and S. Levinson (1987) model of politeness in discourse both informs and is informed by the results of this study, which are also discussed in terms of recent literature on the client's covert experience and in terms of their implications for the practice of therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients' positive and negative expressiveness within their families and alexithymia

49 prospective clients from a midwestern urban community, who sought counseling at a university training clinic, completed the Self-expressiveness in the Family Questionnaire and the 20-item Toronto Alexithymia Scale. As predicted, the positive self-expressiveness scores were significantly negatively correlated -.52 with scores on alexithymia, and the negative self-expressiveness scores were significantly positively correlated .34 with alexithymia. These results support the premise that mental health clients' self-reported lack of positive expressiveness and abundance of negative expressiveness within their family context may be attributes associated with their tendency to be alexithymic.     

Stability and change in mothers' representations of their relationship with their toddlers.

This study examined several issues in the developmental dynamics of parents' representations of their relationship with their toddlers. The authors studied 125 mothers and their firstborn toddler sons over a 13-month period. Mothers took the Parent Development Interview twice, when children were 15 and 28 months of age. Home observations of parent–child interactions and maternal ratings of daily hassles were collected when children were 21 and 27 months of age. The 3 factors that characterized mothers' representations of their 15-month-old firstborn sons (Joy–Pleasure/Coherence, Anger, Guilt–Separation Distress) also fit the data very well for their 28-month-old sons. Although there were no changes in average levels of mothers' (a) joy, pleasure, and coherence and (b) guilt and separation distress from 15 to 28 months, there was a significant increase in mothers' levels of anger. Stability analyses suggested a dynamic relationship between mothers' representations of joy, pleasure, and coherence and of anger over the 13-month period. Finally, changes in mothers' representations were predictable by positive mothering (which led to increased joy, pleasure, and coherence) and by parenting daily hassles (which led to more anger). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist-client sex: Clients' retrospective reports.

Therapists will be more effective practitioners when they understand the factors that contribute to sexual boundary violations. The authors' interviews with former female victims indicated that offending therapists were mostly reputable psychologists working alone, and that boundary violations developed gradually. The clients were often victims of child sexual abuse. Many reported pleasurable feelings during the affair but saw the experience as hurtful or exploitative in retrospect. The authors' findings imply that practitioners should minimize seemingly innocuous physical consolation or self-disclosure, especially with survivors of child abuse. They are encouraged to select offices with other professionals and to participate in peer-supervision activities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients' secret keeping in outpatient therapy.

This research investigated the relation between clients' self-reported secret keeping in therapy and symptomatology. Therapy outpatients at a community hospital (N?=?42) completed surveys that asked them to list relevant secrets that they were keeping from their therapists and their reasons for doing so. Over 40% of the clients reported keeping a relevant secret in therapy, and the most frequently listed reason was that they were afraid to express feelings. After adjusting for clients' initial symptomatology, tendency to keep secrets in general, and social desirability scores, the analyses showed that keeping secrets in therapy was a significant predictor of having fewer symptoms. The results support a self-presentational perspective on secret keeping in counseling and suggest that clients may benefit from hiding some undesirable aspects of themselves from their therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients' perceptions of helpful experiences in counseling.

The question of what clients experience as helpful in counseling was examined via concept mapping, a methodological approach combining qualitative and quantitative strategies. The purpose of the study was to clarify the scope and interrelations among elements of the retrospective experience of helpfulness among 36 clients who had completed counseling after an average of 11 sessions. Five thematic clusters consistent with previous research were identified: Counselor Facilitative Interpersonal Style, Counselor Interventions Generating Client Resources, New Perspectives, and Client Self-Disclosure. Four new thematic clusters were also identified: Emotional Relief, Gaining Knowledge, Accessibility, and Client Resolutions. The structure of the concept map generated by the participants in this study was found to be consistent with an integrative, pantheoretical model of the counseling process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Young children's awareness of the origins of their mental representations.

A series of studies addressed preschool-age children's ability to identify and remember the epistemic and imaginal origins of their mental representations. Study 1 revealed that children as young as 3 were able to differentiate imaginal from perceptual origins. Study 2 explored children's ability to differentiate representations formed through inference from those formed through imagination and seeing. Results revealed that 3-, 4-, and 5-year-olds differed significantly in their ability to identify and remember the sources of their mental representations. Identifying and remembering inference was the most difficult for all age groups. Results from Study 3 rule out the possibility that incorrect performance in Studies 1 and 2 resulted from an inability to remember the objects used in the tasks. Results from these studies indicate that children as young as 3 are able to differentiate mental representations based on fiction from those based on fact, but that this ability continues to develop throughout the preschool years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Misconduct by therapists.

Suggests that, in his retrospective review of malpractice claims against psychologists, R. H. Wright (see record 1982-22006-001) infers beyond the limits of the data he reports. Specifically, he suggests that, because there were so few complaints of sexual misconduct, stories of sex between psychologist and patient are substantially overstated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The education of therapists.

At a conference for female therapists in Canada, participants answered a questionnaire on issues and skills of therapists. Results indicate that the Ss were interested in (1) understanding themselves, their careers, and women's roles in society, and (2) a feminist approach to therapy. The responses suggest that the Ss' training as therapists was inadequate to the extent that it failed to address their own reality and that of women clients. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-talk of group therapists.

To identify group leader cognitions and the role experience may play in leader cognitive schemas, 60 participants were placed in 1 of 3 groups on the basis of group-leading experience and were exposed to a 20-min videotape of a group session, during which they completed a thought-listing instrument. Two judges free sorted the 1,299 collected thoughts and identified and defined 17 distinct thought categories. Three trained judges then placed 1,271 (97.8%) of the thoughts into these categories. Differences among experience levels were also explored through correlation and stepwise multiple regression analyses. Two thoughts, interpretation of group process and internal question regarding member, were found to account for 56% of the variance in experience level. Findings are discussed in terms of group leader cognitive processing, and suggestions for future research are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients' expectancies and their relationship to pretreatment symptomatology and outcome of cognitive-behavioral group treatment for social phobia.

The present study examined the expectancies of clients with social phobia that they would benefit from cognitive-behavioral group treatment. Lower expectancies for positive outcome were related to greater severity of social phobia, duration of social phobia, and depression. Lower expectancies were also reported by individuals with the generalized subtype of social phobia, but expectancies were not further influenced by the presence of other Axis I disorders. Expectancy ratings did not differ between clients who dropped out of treatment and those who did not, but, after pretreatment severity of social phobia was accounted for, expectancies significantly predicted improvement among treatment completers. Clients' expectancy beliefs may be an important factor to address in the prediction of who will benefit from a cognitive-behavioral treatment, even when that treatment has demonstrated specific efficacy. (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)     

Harmful effects of posttermination sexual and romantic relationships between therapists and their former clients.

[Correction Notice: An erratum for this article was reported in Vol 25(4) of Psychotherapy: Theory, Research, Practice, Training (see record 2007-12032-001). Reference was made to the Minnesota law regarding reporting of "any sexual or romantic relationship in which the parties were once therapist and client" (p. 250). Upon further review by the author, it was determined that the law is more complicated than conveyed in the article. A detailed explanation of the law is provided in the erratum, although legal counsel is suggested for further interpretation.] Examines anecdotal evidence regarding the harmful effects of posttermination sexual or romantic relationships between therapists and clients, focusing on relationships between female therapists and former clients who are also women. The question of equality of power between therapists and former clients is addressed. The impact of these relationships on the community in which they occur is considered. It is concluded that posttermination relationships between therapists and clients have the potential to do as much harm as relationships initiated during therapy and that such relationships should be defined as unethical. (PsycINFO Database Record (c) 2010 APA, all rights reserved)