Applying Tarasoff to AIDS-related psychotherapy issues.

This article provides a framework, based on the Tarasoff decision and its sequelae, for examining several confidentiality issues that may emerge in psychotherapy situations related to acquired immune deficiency syndrome (AIDS). Four Tarasoff issues (special therapeutic relationship, dangerousness, identifiable victim, therapist's action to detain and/or warn) are described and applied to therapy situations with clients who have AIDS or are positive for antibodies. Recommendations are provided for psychotherapists dealing with such confidentiality dilemmas. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do Tarasoff principles apply in AIDS-related psychotherapy? Ethical decision making and the role of therapist homophobia and perceived client dangerousness.

The present research assessed the relationship between therapists' beliefs and ethical decision making when working with clients who are HIV positive and who refuse to warn sexual partners or use safe sex practices. The sample consisted of licensed psychologists in Florida. Results demonstrated a significant relationship between homophobia and likelihood of breaching confidentiality. In addition, scenarios depicting highly dangerous clients yielded higher breach scores than scenarios depicting less dangerous clients. The study demonstrated that personal bias may affect professional ethical decision making. Discussion focuses on the need for continued education and self-monitoring in work with highly sensitive and often stigmatized client groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tarasoff: 10 years later.

This article reviews the Tarasoff case and other cases decided since the California Supreme Court issued its decision. The changing interpretation of the decision, the broadening of its applicability, and legislative reactions are also discussed. Recommendations for psychotherapists who may have to make decisions about potentially violent clients are noted. (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)     

Limiting therapist exposure to Tarasoff liability: Guidelines for risk containment.

The "duty to protect" 3rd parties, first imposed by the Tarasoff case, has concerned and perplexed clinicians. A series of guidelines is offered for reducing therapist exposure to suit, based on expert witness experience in a number of cases raising this form of tort liability. These guidelines concern the assessment and management of risk, the documentation of information and activities, the formulation of written policies, and damage control when risk is realized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Reassessing psychotherapy research.

Reviews the book, Reassessing psychotherapy research edited by Robert L. Russell (see record 1994-98237-000). This book, with its international representation of contributors, attempts to address central issues in contemporary ("fourth generation") psychotherapy research. The main tenet is that much dominant psychotherapy research has focused on outcome, curative factors, and scientific rigor and overlooked the richness of therapeutic process. This book does as the title suggests: addresses content and process issues, balanced with methodological sophistication. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Interpersonal psychotherapy of depression.

Reviews the book, Interpersonal psychotherapy of depression by Gerald L. Klerman, Myrna M. Weissman, Bruce J. Rounsaville, and Eve S. Chevron (1984). The authors state their intention to "describe the theoretical and empirical basis for interpersonal psychotherapy of depression," and also "offer a guide to the planning and conduct of the therapy." They do both, and waste no words. The book is organized into three parts. In the first part, the authors present an overview of the theory of the interpersonal approach of the use of interpersonal psychotherapy for depression, objectively offer both favorable and unfavorable findings from completed studies, and outline several studies in progress. The chapters in Part Two clarify how one conducts interpersonal therapy of depression. Part Three addresses the combination of psychotherapy with pharmacotherapy and the professional requirements of the therapist. This book is clearly written, well referenced, and easily understood by beginners who might not have the perspective, as well as by busy veterans who want to learn something new without plowing through mountains of theory and data. It would be useful for students in training, and extremely valuable to the legions of relatively inexperienced front-line mental health center therapists who are required to use time-limited approaches with depressed patients, often without having much structure for what they are doing. More experienced therapists who treat ambulatory depressed patients will add to their clinical skills and enjoy the process. The authors have turned their manual into a useful book that competes most favorably with other texts on short-term approaches to therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Handbook of psychotherapy supervision.

Reviews the book, Handbook of psychotherapy supervision by C. Edward Watkins Jr. (see record 1997-08923-000). This book offers a forum for some of the most influential thinkers of our time to discuss what is probably the most critical aspect of learning how to become a therapist: clinical supervision. The book is well organized, comprehensive, and informative. In it, the elusive nature of teaching how to conduct psychotherapy is explored and clarified from a variety of perspectives and across myriad contexts. Overall, the book provides a wealth of information in an organized and readable fashion. Nonetheless, the topics explored include some areas that were not covered adequately. For example, the book would have been further enhanced had the subject of supervisory failures been given more attention, as we know that learning from past errors often provides the most valuable teaching opportunities. Despite a few minor criticisms, the book serves as a wonderful reference for practitioners, students, and teachers of psychotherapy. While extremely useful for the beginning supervisor, the book is also a valuable resource for seasoned supervisors who wish to expand or challenge their ways of thinking about supervision. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Countertransference in psychotherapy with children and adolescents.

Reviews the book, Countertransference in psychotherapy with children and adolescents edited by Jerrold R. Brandell (see record 1992-97833-000). Books on child analytic work are rare, and books on countertransference in child treatment are basically nonexistent, despite the proliferation of writing on countertransference in work with adults. Thus, Jerrold Brandell's edited volume is a welcome and long-overdue addition to the literature. Although the book is not strictly about analysis, it is analytically informed. Brandell's stated goal is to advance the principle that "countertransference is a ubiquitous factor in child and adolescent treatment, and that its recognition, understanding, and management are essential to effective psychotherapy." This is indeed a worthy if not essential undertaking, and the collection of articles in Brandell's book advances this goal. Brandell prefaced the chapters with his own thorough historical literature review of countertransference in both adult and child work. He then subdivided the book into two sections, with the first containing two classic articles an countertransference and the bulk of the book devoted to the following "scientific situations" in child psychotherapy: racial and cultural issues, depressed and suicidal children and adolescents, infant-family treatment, severely disturbed adolescents, eating disorders, abused children and adolescents, parent loss and divorce, borderline children and adolescents, life-threatening illness, and substance-abusing adolescents. This book is a very good resource for child analysts and therapists, especially those who espouse a more relational or intersubjective point of view. It is suitable both for inexperienced analysts and as a reminder to more seasoned ones of the importance and pervasiveness of countertransference issues in our work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religious language in psychotherapy: Dyadic and triadic configurations.

In this article, clinical material from 3 patients with psychotic liabilities who introduced religious cosmologies into the psychotherapeutic situation is examined. These constructions did not occur in the context of an ongoing faith experience or long-standing participation in a religious community. One way of understanding these narratives is through dyadic and triadic configurations. In some cases, the introduction of a God representation is an attempt to withdraw from the therapeutic dyad into one of more omnipotence, promise, and hope. In others, the introduction of the God representation serves the purpose of locating a lawful Third to the regressive forces of the therapeutic dyad. The purpose of the Third is to structure the roles and relationships of the participants and to moderate the effects of regression inherent in a dyadic configuration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Handbook of psychotherapy and behavior change.

Reviews the book, Handbook of psychotherapy and behavior change by Sol L. Garfield and Allen E. Bergin (1986). The third edition of the Handbook is an 886-page volume, complete with author and subject indices. It contains 19 chapters divided into six parts; each chapter is written by established authorities. The six divisions into which the chapters have been separated include Historical, Methodological, and Conceptual Foundations; Evaluation of Process and Outcome in Psychotherapy and Behavior Change; Behavioral and Cognitive Therapies; Child and Family Therapies; Special Topics; and Evaluating the Training of Therapists. This volume represents "a critical appraisal of existing empirical research findings with an evenhanded or eclectic attitude toward divergent orientations in the area of psychotherapy and behavior change along with their implication for research and practice." Notably, the editors' critical but even-handed appraisal of the field now includes satisfaction with "an increased sophistication in the design of research on psychotherapy" as well as "the introduction of specific training manuals that allow for a greater specification and monitoring of the operations of specific therapies." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Counseling and psychotherapy of work dysfunctions.

Reviews the book, Counseling and psychotherapy of work dysfunctions by Rodney L. Lowman (see record 1993-98413-000). Dr. Lowman's book on work dysfunctions serves as a seminal product for further understanding a much-neglected component of the lives of the many men and women who seek psychological assistance in working through issues around their employment. The book conveys in a well-written, sometimes humorous, style that "work is a natural part of living, and the issues it raises are important parts of character." The overall impression is that of a well-thought-out and most readable book. There is no doubt in this reviewer's mind that it will become essential reading for psychologists, social workers, family therapists, and graduate students who are becoming increasingly involved in this field of study. What this reviewer found very helpful was the clarity of presentation of the assessment techniques as well as the amply illustrated intervention modules that may be utilized. To this reviewer, there is no doubt that this is one area for psychologists' contributions in the future--the work area. Lowman's book gives us basic material from which to continue to build our profession in a new and exciting direction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tarasoff and the researcher: Does the duty to protect apply in the research setting?

In the decade since the Tarasoff decision, psychotherapists have become increasingly concerned about their responsibility to protect potential victims of their patients' violent behavior. Similarly, researchers in the mental health professions have expressed growing concern over their possible parallel obligations with regard to their research subjects. No case law to date imposes such a duty on researchers, but our analysis suggests that the congruence between the training and function of clinical researchers and psychotherapists will provide the touchstone for application of the duty to protect. In this article we discuss the issues that researchers should consider in assessing their potential duties. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Values: The enfant terrible of psychotherapy.

Cites clinical examples, personal experience, and empirical research demonstrating that the values of psychotherapists affect diagnoses, as well as the process and goals of therapy. Some therapists believe that values should not influence therapy. Thus, indirect ways of dissemination of values may be used as shown by clinical illustrations. The author holds a value-determined image of psychotherapy, in which therapeutic schools are viewed as "perceptual houses" to which the client is being converted. The advantages of making the public aware of the role of values in psychotherapy are briefly discussed. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Group psychotherapy with addicted populations.

Reviews the book, Group psychotherapy with addicted populations by Philip J. Flores (1988). Dr. Flores has written a handbook which provides a well-documented overview on abstinence-oriented group psychotherapy for chemically (i.e., alcohol and drug) dependent populations. Practitioners, teachers, and students in a variety of disciplines will appreciate this volume's integration of diverse perspectives and also its detailed index. Overall, the reviewer feels that the book has merit. The reviewer found it well written with an admirable combination of conversational and scholarly styles and excellent use of case illustrations. There is information in this volume of value to the novice as well as the experienced group therapist. This book, however, has some flaws and notable omissions. First, the words "addicted populations" in the title may mislead some, who may not realize that the focus is primarily on alcohol and secondarily on illicit drugs, while other habitual or compulsive behaviors (cigarette smoking, eating disorders, etc.) are not mentioned at all. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The complete psychotherapy treatment planner.

Reviews the book, The complete psychotherapy treatment planner by Arthur E. Jongsma Jr. and Mark Peterson (see record 1995-97453-000). The call for documentation of treatment effectiveness and an accountability of process has spawned a genre of treatment guides intended to help psychotherapists develop a practical framework through which they can meet these expectations. This text by Jongsma and Peterson is first quality in that it is both user friendly and has the depth and comprehensiveness necessary for thorough, accurate, and systematic recording. The format of the text is a six step process for developing a treatment plan applied to 34 clinical problem areas. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Comprehensive handbook of psychotherapy integration.

Reviews the book, Comprehensive handbook of psychotherapy integration edited by George Stricker and Jerold R. Gold (see record 1993-97695-000). This book is a survey of the psychotherapy integration movement and offers new perspectives of practical significance. The reviewer presents a summary of the information presented in the chapters and then concludes with the statement that this volume is of substantial import and usefulness. It provides a valuable contribution to the field. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Comprehensive handbook of psychotherapy integration.

Reviews the book, Comprehensive handbook of psychotherapy integration by George Stricker and Jerold R. Gold (see record 1993-97695-000). In the Preface to this text, the editors express their expectation that "this volume will serve as an up-to-date and exhaustive overview of the status of ongoing scholarly and clinical work in the integration of the major schools of psychotherapy" (p. ix). Such introductory comments are commonly found in the "handbook" genre, yet such expectations are seldom met to the satisfaction of many reviewers. Nevertheless, with an open mind I plunged into this 560-page, doubled-columned, 37-chapter volume. I will admit that I was somewhat devilishly compelled to find some topic mat I could consider less than exhaustively reviewed. Well, did I find the volume exhaustive? The answer is yes! This is a marvelous volume. It should be mandatory reading for students in advanced counseling and psychotherapy courses. Initially, one would think its value is as a reference text, and indeed, all practicing psychotherapists should have a copy of this volume on their shelves. But, this volume provides such a useful series of pragmatic chapters, I believe that advanced students would prosper as well. True integration occurs on both the theoretical and practical levels. This is the first book that I have seen that provides the reader with exhaustive perspectives on both. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The psychotherapy of the self.

Reviews the book, The psychotherapy of the self by Hyman L. Muslin and Eduardo R. Val (see record 1987-98090-000). This book is written for mental health professionals. Its intention is to present criteria for psychopathology from a self-psychological viewpoint. Based on a differential diagnosis, a psychoanalytic treatment modality is suggested that is judged to be most suitable to the assessed psychopathology. This book offers excellent clinical material, presented in detail, with an ongoing commentary which illuminates the interviewer's interpretation of the data presented. The problems with the book do not lie in the clinical material presented. Its problems result from the way in which the material is organized and the theoretical claims that are stated or implied. A more controversial but equally important criticism of the book is the manner in which data collection and the relationship between therapist and client are conceptualized. The reviewer found the book to contain some major shortcomings. It is theoretically lacking, though clinically stimulating. A reader will find the book valuable for its clinical material and the manner in which this is presented. In addition, there are insights to be gained relating to the functioning of the therapist as he or she experientially participates in the process of psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Experiential psychotherapy: Basic practices.

Reviews the book, Experiential Psychotherapy: Basic Practices by Alvin R. Mahrer (1983). What I liked most about this book was its consistent preoccupation with the phenomenology of the patient. This is a topic which never fails to intrigue me, and a sensitivity to another person's world looms large here. However, what frankly disturbs me is a proposition central to most of Mahrer's presentation, and that is the emphasis he places on the futility of assuming two phenomenal worlds in dyadic psychotherapy. The crux of "the method" is the learned skill of reading one's own entrails (my phrase, not his) as a way of verifying the "true" identity of the patient's (therapist's?) reality. The entire book is fundamentally an attempt to illustrate this "merging" of the two into one, and the frustrating "unmerging" which ebbs and flows through the antagonistic process of merging. perhaps the greatest reservation I have about the case Mahrer makes for his practices is the persistent absence in this book of even casual references to outcome events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)