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)     

The impact of power in therapeutic relationships

Power is an important factor in how health care is delivered. Neither health care professionals nor clients fully appreciate the power that they exercise, nor how they influence others. Understanding how power works, however, is vital to establishing a helping relationship. In a traditionally rigid health care system, professionals who try to empower clients can create conflicts among colleagues. A possible solution is an explicit contract with a client, setting out the responsibilities of those involved.     

Building therapeutic relationships with couples.

Contends that the ultimate goal for couples' work in therapy is not the salvation of the marriage but the fullest possible life for each individual. Couples are viewed as systems, and the contributions of general systems theory to couples treatment are illustrated in 4 clinical vignettes. It is suggested that the concept of projective identification is central to understanding and working with couples. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of the therapeutic alliance in psychotherapy.

Traces the development of the concept of the therapeutic working alliance from its psychodynamic origins to current pantheoretical formulations. Research on the alliance is reviewed under 4 headings: the relation between a positive alliance and success in therapy, the path of the alliance over time, the examination of variables that predispose individuals to develop a strong alliance, and the exploration of the in-therapy factors that influence the development of a positive alliance. Important areas for further research are also noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internalization of therapeutic relationships in short-term psychotherapy.

Structural Analysis of Social Behavior was used to chart the internalization of the therapeutic relationships of 48 clients in short-term psychotherapy at 2 university counseling centers. After initial and final sessions, clients reported their perceptions of counselors' actions and attitudes toward them, their own actions and attitudes toward counselors, and their intrapsychic dispositions. Results suggested clients internalized dispositions that they perceived counselors held toward them. Furthermore, results indicated that clients perceived interpersonal complementarity at the beginning but that the degree of interpersonal complementarity did not increase over time. In contrast, clients perceived a lack of interpersonal–intrapsychic complementarity early in therapy but perceived an increase in this complementarity at the end of therapy. This study proposes an integration of interpersonal and psychodynamic theories of psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring countertransference and attitude in therapeutic relationships.

Significant results were obtained establishing a relationship between the therapist's attitude of liking or disliking for his or her clients and countertransference. If strong feelings of liking are present, clients are viewed as having personalities closer to the therapist's personality than are the client's measured personalities. When strong feelings of disliking are operative, the therapist's distortion of the client's measured personality runs in the opposite direction and is viewed as more dissimilar from the therapist's personality than it is measured to be. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of relationship and technique in therapeutic change.

This article discusses varying perspectives on the role of technique and the relationship in therapeutic change. The theoretical assumptions underlying the debate are briefly described, as are the positions of humanistic, behavioral, psychodynamic, and experiential orientations. Theory and research that consider the integration of relationship and technique are presented. It is then proposed that there are general principles of therapeutic change that are facilitated by both the relationship and technique. It is suggested that these principles of change should be seen as the active ingredients of therapy, thereby moving the field away from a debate about whether technique or the relationship is more important. Instead, an emphasis on studying general principles of change and the processes by which technique and relationship facilitate these principles is encouraged. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of bronchial arteriography and therapeutic embolization in hemoptysis

A case is presented which demonstrates the value of bronchial arteriographic studies in localizing and treating hemoptysis. The patient was bleeding from an old post-tuberculous bulla and for several reasons was not a candidate for surgery. Bronchial arteriographic studies demonstrated both hypervascularity in the region of the cavity and also a mycotic aneurysm of a bronchial artery. After therapeutic embolization with gelatin (Gelfoam), the hypervascularity and aneurysm were no longer opacified. Active bleeding abruptly ceased and, except for a single mild recurrence, has not recurred during the three months since therapeutic embolization. The major theoretic risk of bronchial arteriographic study and therapeutic embolization is spinal injury. It is believed that permanent injury can almost be avoided, providing proper technique is used.     

The role of dislocations in the flow stress grain size relationships

Calculations involving pile ups of dislocations, both analytical and numerical, using either discrete dislocations or continuous distribution of dislocations of infinitesimal Burgers vectors, are reviewed in the light of their effects on the relation between yield or flow stress and grain size. The limitations of the pileup models are discussed and some nonpileup theories of yielding are critically reviewed also. More critical experiments are still needed to reveal the fundamental mechanicm of yielding.     

The role of temporal relationships in the transfer of conditioned inhibition

We have cloned and molecularly and functionally characterized the first human member of the family of Ca2+-activated Cl- channels, human (h) CLCA1. The 31,902-bp gene is located on chromosome 1p22-31 and is preceded by a canonic promoter region that contains an L1 transposable element. In contrast to all previously known homologs in other species, hCLCA1 is exclusively expressed in intestinal basal crypt epithelia and goblet cells, suggesting that it does not represent the human counterpart of any of them. Expression of the 914-amino-acid hCLCA1 protein in HEK 293 cells yielded a 125-kDa precursor that was processed to yield two cell-surface-associated subunits, a 90-kDa protein and a group of 37- to 41-kDa proteins. Four transmembrane domains were established within the 90-kDa subunit. HEK 293 cells transfected with CLCA1 exhibited an increase in whole-cell Ca2+-sensitive Cl- currents that were outwardly rectified and inhibited by 4,4'-diisothiocyanatostilbene-2, 2'-disulfonic acid, dithiothreitol, and niflumic acid. Cell-attached patch recordings of transfected cells revealed single channels with a slope conductance of 13.4 pS. These findings suggest that human CLCA1 mediates a Ca2+-activated Cl- conductance in the human intestine and make it an interesting candidate as a modulating factor in the pathogenesis of cystic fibrosis.     

The role of therapeutic group programs in a nursing home.

Notes that nursing homes have traditionally focused their care on 3 areas—basic custodial services (e.g., food and shelter), physical health care, and personal care (e.g., grooming and toileting). Psychosocial services have been absent from the long-term care setting. A range of group therapeutic options is available, including activities therapy, occupational therapy, reality orientation, remotivation, and behavioral therapy; these and other approaches are discussed. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Safe closure of therapeutic relationships with abuse survivors

1 Safe closure of a therapeutic relationship is needed because neither healer nor client can be a "stranger" again. 2 A "failed termination" may overshadow the therapeutic gains that were made during the working phase, constituting a "retraumatization." 3 Closure, as opposed to termination, involves a unique, individualized mutual transformation of the therapeutic relationship into a "real relationship."     

Regulation processes in intimate relationships: The role of ideal standards.

This research investigated the consistency between partner perceptions and ideal standards (ideal-perception consistency) and the partner regulation attempts of 200 individuals involved in relationships (Study 1) and 62 heterosexual couples (Study 2). As predicted, greater regulation attempts were associated with lower ideal-perception consistency, and these links operated within 3 pivotal mate-evaluation dimensions and were moderated by perceived regulation success. Ideal-perception consistency also mediated the relation between partner regulation and relationship quality, and cross-lagged analyses suggested that ideal consistency and regulation influenced each other over time. Finally, stronger partner regulation was generally associated with more negative self-evaluations and more self-regulation by the targeted partner. These novel results support and extend the Ideal Standards Model (J. A. Simpson, G. J. O. Fletcher, & L. Campbell, 2001). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexualization of therapeutic relationships: The dual vulnerability of patient and therapist.

Contends that consumerism (a humanistic-egalitarian therapeutic orientation) and feminism have heightened awareness of the problem of sexual intimacies between patients and therapists. Evidence suggests that sexual intimacy between patients and their therapists has become a more common mode of experience than previously thought. Sexual abuse occurs when the relationship between the patient and therapist is violated, and the patient is victimized by the therapist; erotic involvement between patient and therapist has been likened to incest. Data from the 1970's show that the overwhelming majority of sexually abusive therapists are male. Education during therapists' training period and alternatives for therapists at risk for sexually abusive behavior, including avoidance, referral, treatment programs, and punishment, are suggested as ways to deal openly with this small but severe problem. Public education, in a nonalarmist manner, is also recommended. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trainees' experiences of role conflict and role ambiguity in supervisory relationships.

The nature and extent of counselor trainees' experiences with role difficulties were examined in the context of supervision. Role ambiguity arises when trainees are unsure of supervisory expectations for their performance or evaluation; role conflict arises when trainees encounter opposing expectations for their behavior. The Role Conflict and Role Ambiguity Inventory was developed and validated with trainees and supervisors in practicum, internship, and postinternship settings. Results indicate that the inventory is both reliable and valid. As hypothesized, role difficulties were predictive of more work-related anxiety, general work dissatisfaction, and dissatisfaction with supervision. Beginning trainees reported higher levels of role ambiguity than did more experienced trainees. Role conflict seems to be problematic only for advanced trainees, for whom ambiguity is minimal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of aggressive personality and family relationships in explaining family conflict.

This study investigated whether genetic and environmental influences on global family conflict are explained by parents' personality, marital quality, and negative parenting. The sample comprised 876 same-sex pairs of twins, their spouses, and one adolescent child per twin from the Twin and Offspring Study in Sweden. Genetic influences on aggressive personality were correlated with genetic influences on global family conflict. Nonshared environmental influences on marital quality and negative parenting were correlated with nonshared environmental influences on global family conflict. Results suggest that parents' personality and unique experiences within their family relationships are important for understanding genetic and environmental influences on global conflict in the home. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The therapeutic role in later life: husbands, wives and couples

The present study investigates the extent to which marital partners are different or similar in their ways of enacting the therapeutic, or supportive, role. Specifically, the article compares husbands and wives categorically as in non-dyadic studies and then as marital partners as in dyadic studies. In addition, this study, by using data from the Aging Couples Study, included only dual-earner couples so as to control for the effects of work life on marital relations. Results showed that studies of individual married men and women understate the differences between marital partners in that some wives "overbenefit" in the exchange of conjugal supports. However, husbands more often "overbenefit." Findings also indicated that the norm of reciprocity does not prevail regarding the extent of support, although it does for the types of support exchanged.     

Going beyond social support: The role of social relationships in adaptation.

Discusses new directions for explicating relations among stress, support, and adaptational outcomes. Attention is drawn to the distinctiveness of marriage as a source of stress and support in adult life. In addition, the literature on marital and family therapy points to the potentially deleterious effects of overinvolvement in close relationships. It is suggested that if research and theory on social support are to become relevant to clinical intervention, the current emphasis on the benefits of perceived social support needs to be balanced by consideration of the costs constraints of participating in social relationships and by a concern for how such perceptions arise. (83 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)