Therapists’ use of congruence in nondirective play therapy and filial therapy.

Although the U.S. child-centered approaches of Garry Landreth and Louise Guerney have the same principles and practice skills as nondirective play therapy as practiced by therapists trained at the University of York, there are a few differences in their approach. Therapists’ practice of “congruence” is actively encouraged for York-trained therapists but not for Landreth and Guerney-trained therapists. The theoretical and practice rationales for expressing congruence that underlie the York approach are examined here, as well as potential pitfalls. Examples of therapists and parents verbally expressing their congruent feelings in therapy are given from both play therapy and filial therapy practice. Special attention is paid to the need for and uses of congruence when helping children and young people who were maltreated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Families and alcoholism: Developments in practice, research, and theory.

Reviews the books, Alcoholism treatment: An integrative family and individual approach by D. I. Davis (see record 1988-97811-000); Substance abuse and family therapy by E. Kaufman (1985); and The alcoholic family by P. Steinglass, L. A. Bennett, S. J. Wolin, and D. Reiss (see record 1987-98538-000). The book by Davis and Kaufman primarily address marital and family therapy (MFT) methods. The Steinglass et al. book presents a long-term, systematic program of theory development and research aimed at understanding the family system dynamics of alcoholic families. Davis provides excellent chapters on strategies for use in identifying and confronting alcohol problems and in getting a commitment from the family to work toward elimination of the problem drinking. The Davis book is an excellent resource; however, family and other therapists reading this book will need other resources for dealing with severe alcoholics, for moving rapidly to attain abstinence, and for dealing with long-term recovery. Kaufman's book is an excellent resource for family therapists wanting to learn more about dealing with alcoholism and other forms of substance abuse and for substance abuse therapists to learn about family therapy. The alcoholic family is an excellent book that will become a classic on this topic. We would recommend it for the serious clinician who wants a theoretical framework to guide decisions about therapeutic approaches with alcoholic families. We recommend all three books quite highly to practicing clinicians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceptions of the psychotherapy relationship in long- versus short-term therapy.

Examined participant perceptions of therapy by comparing long- with short-term therapy dyads. 30 therapy dyads from 3 large midwestern community mental health centers were included. Therapists and clients (20–49 yrs old) completed the Therapy Session Report 4 times and the Survey of Interpersonal Values twice immediately following scheduled therapy sessions. Results indicate that therapists and clients in long-term therapy dyads were more phenomenologically congruent in their feelings toward psychotherapy and each other and in their perceptions of therapeutic goals and processes than were therapists and clients in short-term therapy dyads. Often these perceptions were shared at the very outset of therapy. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some "short-term therapy values" are a formula for invisible rationing.

From a review of the literature, S. Budman and A. Gurman (see record 71-04498; see also 1988) proposed that the difference between brief therapists and longer term therapists lies in their value systems. They argued that the short-term therapist's value system is superior to the long-term therapist's and use the value system as a foundation for a brief psychotherapy theory. However, on examination, the arguments favoring the superiority of Budman and Gurman's short-term therapist's values are based on logical flaws and pseudofactual beliefs. These values actually compromise the client's best interest, while providing justifications for rationing treatment. Because the justifications are blended into a theory that asserts to have superior values, the consumer is often unaware of the rationing. In addition, misleading language further obscures the fact of rationing. As a result, these values can lead to the ethically questionable practice of invisible rationing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist qualities preferred by sexual-minority individuals.

Psychotherapy research concerning lesbian, gay, and bisexual (LGB) individuals has focused on matching clients on gender and sexual orientation, yet has not considered how factors such as therapeutic skill, presenting problem, and cohort membership may influence preference for therapists. This study was designed to identify those therapist qualities that sexual-minority individuals prefer and to determine how the presenting problem influences therapist choice. Forty-two nonheterosexual adults between 18 and 29 years old ranked 63 therapist characteristics from "Extremely Uncharacteristic" to "Extremely Characteristic" when seeking treatment for a problem in which their sexual orientation was salient and one in which it was not. The analyses of both conditions yielded clusters of items reflecting therapist characteristics that participants considered unfavorable, neutral, beneficial, and essential. Participants valued therapists who had LGB-specific knowledge as well as general therapeutic skills, whereas they indicated that they would avoid therapists who held heterocentric views. Application of these findings to clinical practice and future directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experienced therapists’ approach to psychotherapy for adults with attachment avoidance or attachment anxiety.

Interviews were conducted with therapists (N = 12) nominated by peers as especially effective in working with clients with adult interpersonal problems. Open-ended questions asked how these therapists would approach 2 adult clients described in brief vignettes as having high attachment avoidance or anxiety. A coding team used a grounded theory approach to identify 8 higher order themes in the interviews: Conceptualization, Client Defenses, Managing Boundaries, Markers of Progress, Therapist Reactions, Targeted Interventions, Corrective Relational Patterns, and Internal Representations and Models. These themes were integrated into an inclusive theoretical model based on the core concept of therapists’ strategic management of therapeutic distance. The distance necessary to engage clients initially is adjusted later in therapy to create a corrective attachment in the psychotherapy relationship that facilitates change. Therapists described how, after engagement, they gradually increase therapeutic distance for clients with attachment anxiety who must then manage resulting frustration while learning to function more autonomously. Therapists gradually insist on decreased therapeutic distance to help clients with attachment avoidance overcome their fears of intimacy. Therapists discussed the specific techniques they use to manage therapeutic distance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Emotion-focused therapy: Coaching clients to work through their feelings.

Reviews the book, Emotion-focused therapy: Coaching clients to work through their feelings by Leslie S. Greenberg (see record 2002-00066-000). This book was written for both novice therapists who have had little experience working with emotions in treatment, as well as for experienced therapists looking to systematize their understanding of how emotional change works. The book is divided into four parts. Part I examines the nature and function of emotions. Part II examines the first part of emotional coaching--arriving at emotion. Part III examines the second part of emotional coaching--leaving emotion. Finally, Part IV examines the application of emotion-focused therapy to the problems of living, in the context of individuals, couples therapy, and parenting. This book offers a wealth of therapeutic techniques and theoretical principles about the process of change. As such, it is an important and natural companion to seminal works in cognitive behaviour therapy and interpersonal therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Congruence in nondirective play and filial therapy: Response to Ryan and Courtney.

Differences in the training of nondirective play therapists between University of York (U.K.) approach and the Guerney and Landreth approaches (U.S.) has been raised by Ryan and Courtney (2009). York-trained therapists are encouraged to initiate expression of their own feelings at selective times to assure that therapists are congruent in their relationship with children in nondirective play-therapy. Congruence, an important component of the necessary and sufficient conditions for therapeutic personality change (Rogers, 1957), is based on the importance of therapist genuineness to maintain a trustful and safe therapeutic relationship. This article compliments Ryan and Courtney (2009) for introducing the importance of congruence in play therapy. The assumptions of nondirective play therapy in the Guerney approach was influenced significantly by their development of filial therapy and to the training of parents and therapists, This article asserts that congruence, in the Guerney approach, is incorporated by therapists expressing their own feelings only when this is initiated overtly or covertly by the child. Responding to a child in this way is dependent on the empathic attunement to a child's emotional motivation by a skillful parent or therapist. This raises questions about whether a nondirective stance is maintained in the York approach. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Helpful and hindering events in psychotherapy: A practice research network study.

This paper presents the findings of a psychotherapy process study conducted within the Pennsylvania Psychological Association Practice Research Network (PPA-PRN). The investigation was the product of a long-term collaborative effort, both in terms of the study design and implementation, between experienced clinicians of various theoretical orientations and full-time psychotherapy researchers. Based on a relatively large sample of clients seen in independent practice settings, close to 1,500 therapeutic events (described by clients and therapists as being particularly helpful or hindering) were collected. These events were coded by three independent observers using a therapy content analysis system. Among the findings, both clients and therapists perceived the fostering of self-awareness as being particularly helpful. The results also point to the importance of paying careful attention to the therapeutic alliance and other significant interpersonal relationships. The merits and difficulties of conducting scientifically rigorous and clinically relevant studies in naturalistic contexts are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The future of psychotherapy: A Delphi poll.

Predicted psychotherapy trends in the next decade by using the Delphi poll. 36 therapists and researchers completed a 100-item questionnaire assessing possible changes in therapeutic interventions, psychotherapists, therapy modalities, theoretical orientations, research findings, and professional issues. Results indicate that therapy will become more cognitive behavioral, present centered, problem specific, and briefer; cathartic, aversive, and dynamic approaches are expected to decrease. Family and marital therapy are predicted to markedly increase; long-term individual modalities are expected to markedly decrease. Optimistic forecasts include an increase in women and minority therapists, accelerated services to underserved populations, coverage under national health insurance, and standard implementation of peer review. One emerging pattern suggests that psychotherapists' efforts at change will become more similar to self-change processes that are used by people in their natural environment. The impermanent nature of psychotherapy and the deleterious consequences of this impermanent condition are discussed. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does development do the deed?: Clinical experience and epistemological development together account for similarities in therapeutic style.

Introduces the concept of epistemological development as a variable that may bring some clarity to mixed results regarding the relationships among theoretical orientation, clinical experience, and the conception of an ideal therapeutic relationship, and therapeutic style. Data are reported on the relationships among the aforementioned variables for 161 therapists (aged 23–69 yrs) of 6 distinctive theoretical schools. Results suggest not only that orientation is far more responsible than experience for variation of therapeutic styles, but also that differences between more and less experienced therapists only arise when high levels of both experience and epistemological development are present. Results also suggest that a group composed of more experienced and more developed cognitive and psychodynamic therapists was more homogeneous in therapeutic style than the group composed of all other therapists of the same orientations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive behavior modification: Misconceptions and premature evacuation.

Examines and evaluates A. B. Ledwidge's (see record 1979-04191-001) recent implication that cognitive behavior modification is "a step in the wrong direction." Misconceptions about the alleged differences between cognitive and behavior therapists are noted, with particular emphasis on metaphysical dualism and dichotomous categorization. The classification of therapists according to the techniques that they employ is also questioned. It is argued that procedural overlap is common across schools of therapy and that categorical distinctions—when they are possible—are more likely to be valid when they are based on theoretical assumptions rather than on therapeutic techniques. The argument that behavior therapists rely almost exclusively on nonverbal means is challenged, as is the assertion that cognitively oriented therapists "rely chiefly on speech as the instrument of change." Finally, it is argued that Ledwidge's cautions about the continuing pursuit of cognitive-behavioral techniques are themselves premature and contrary to the commitment to empirical evaluation shared by both cognitive and less cognitive behavior therapists. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Process and practice in family therapy (second edition).

Reviews the book, Process and practice in family therapy (second edition) by Gerald H. Zuk (1986). This book is an elaboration on the views on family therapy Zuk presented in the first edition, published in 1975. The book consists of three parts. Part I provides most of the theoretical and philosophical considerations underlying the author's conceptualization of family therapy. Parts II and III offer more specific illustrations of these considerations. Zuk wrote this book for the mental health clinician who works primarily with couples and families. He expects that all mental health professionals will find interesting material in it. In this reviewer's opinion the book is of special value for the more experienced family therapist who is able to incorporate various theoretical views into a consistent treatment plan. For beginning family therapists and for mental health professionals without experience in marital or family therapy the material offered may be too specific and the translation gap between theory and practice too large. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mapping the Characteristics of a 'Good' Play Therapist.

In this pilot study, concept mapping, a methodological approach combining qualitative and quantitative analytic strategies, was used to identify the therapist qualities, competencies, and skills necessary for effective play therapy outcomes as perceived by a sub-sample of 28 experienced play therapists who are members of the Association for Play Therapy (APT). The clusters associated with the therapeutic relationship and facilitative skills (e.g., empathy, warmth, and genuineness) were rated as the most essential skills to possess and also as the most difficult to develop. In contrast, the clusters associated with play therapy interventions and theories were rated as the least important skills to possess but as the easiest to acquire. The findings are discussed, with implications for therapeutic practice, research, and policy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A therapeutic community: Theory and practice.

Describes a therapeutic community approach to psychotherapy in a large group practice of over 275 clients and 15 therapists. The 3 treatment modalities of individual therapy, ongoing group therapy, and periodic marathons, supplemented by family therapy, marital therapy, and by special groups and workshops, form an integrated instrument for change. (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)     

Concepts, processes and procedures: An introduction to the special issue on integration of concrete operating procedures.

Mahrer (1989b) described integration on the basis of concrete operating procedures as one of the more promising approaches to psychotherapy integration. In an attempt to examine this integrative approach, therapists from a variety of theoretical orientations were invited to share examples of how they had integrated into their preferred therapeutic approach interventions that were originally developed outside that framework. The articles in this special section provide illustrations of integration of specific procedures into four different theoretical frameworks. Although the articles discuss the incorporation of a wide variety of different types of interventions, as a group they suggest (a) that therapist operating procedures are understood more in terms of providing resources for an active collaborating client than as creating an impact upon the client, (b) that all therapist activities including procedures aimed at achieving problem resolution instantiate the therapeutic relationship, thus blurring the distinction between working on the relationship and working on client issues, and (c) that it is both possible and valuable for therapists to be flexible and creative in integrating new procedures into their therapeutic work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive practice in family therapy

Positive practice, a brief integrative approach to consultation with families, is described in this paper. A clear distinction is made between the stages of planning, assessment, therapy, and disengagement. Guidelines for progression from one stage to the next are provided. Frameworks for deciding who to invite to preliminary sessions and methods for planning and organizing lines of inquiry are incorporated into this approach to practice. A three-column model is used to construct formulations. The model allows therapists and clients to map information about the pattern of interaction around the presenting problem, beliefs that constrain family members from altering their roles in these problem-maintaining patterns, and factors that have predisposed family members to hold these beliefs. Positive practice offers methods for evolving new behavioral patterns and belief systems within sessions and for arranging homework tasks for clients between sessions. It also incorporates methods for dealing with resistance, for managing therapeutic crises, for convening individual sessions and broader network meetings, for disengaging from the consultation process, and for recontracting for further episodes of therapy. This evolving approach to practice draws on ideas from many traditions within the family therapy field and takes account of recent research relevant to the practice of family therapy.     

Length of psychotherapy for clients seen in private practice.

Length of treatment for all clients (N?=?100) seen for psychotherapy during 1975 by 7 therapists in a private practice psychological clinic was examined to determine the relative frequency of long-term (>25 sessions) vs short-term (≤25 sessions) psychotherapy. Clients were young, middle class, intelligent, and mildly to moderately disturbed. The median length of treatment was 8 sessions. Fully 80% of the clients had left treatment before receiving 25 sessions. This finding mirrors the trend for public treatment settings. Results reaffirm the necessity of further research and development of short-term treatment techniques designed to effectively utilize the brief time even private clients spend in psychotherapy. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Theory and practice of brief psychotherapy.

Reviews the book, Theory and practice of brief psychotherapy by Simon H. Budman and Alan S. Gurman (1988). This book provides an excellent view into the theory and practice of effective brief therapy. In this comprehensive and well-written joint effort, the authors present and richly illustrate a brief treatment model that integrates the intrapsychic with the interpersonal, showing how skillful and motivated therapists who value pragmatism and flexibility can formulate and conduct therapies in a parsimonious, cost-effective manner. The authors emphasize that brief (or "time-sensitive") therapy is defined not by a certain number of treatment sessions but rather by the quest to be efficient and to get the job done as quickly as possible. Each chapter is full of basic principles, cogent research findings, and good clinical examples that will help the reader to be a more efficient therapist. This book should become basic reading for all therapists, in training or continuing their education, who want to learn more about how to get the job done efficiently. (PsycINFO Database Record (c) 2010 APA, all rights reserved)