Measuring loneliness in different relationships.

Describes the construction and preliminary validation of the Differential Loneliness Scale (DLS), a measure that differs from previous scales in that it asks respondents to evaluate the quality and the quantity of their interactions in specific kinds of relationships. During test construction, item analyses were undertaken to lessen content saturation due to depression, anxiety, and self-esteem and to minimize the response-style bias of social desirability. The reliability of the scale is high, with Kuder-Richardson-20 coefficients ranging from .90 to .92, and test–retest coefficients of .85 and .97 for males and females, respectively, over 1 mo. Preliminary evidence suggests that the scale has concurrent validity against several criteria. Moreover, principal component analyses indicated that the DLS has substantive and structural validity. The scale also has student and nonstudent versions. It may be of value in the differential prediction of loneliness in specific kinds of relationships. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A therapeutic index: Measuring therapeutic actions in psychotherapy.

This article describes a research method that measures a therapist's effectiveness by assigning a composite value to each therapeutic verbal statement during a session. The intrasubject averaging of these values is called the mean therapeutic index (Σ). In this study, whether the mean therapeutic index could be used to predict treatment outcome was investigated. A successful case and an unsuccessful case were selected for 15 therapists, and an early session for each case was coded using the mean therapeutic index. The results show that the magnitude of the effect of the mean therapeutic index, as indicated by the correlation coefficient r, was .92. Thus, the mean therapeutic index accounted for 85% of the variance in the classification of treatment outcome as successful or unsuccessful. The findings point to the method's potential use for clinical practice and supervision of psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Managing countertransference.

In this article, we review the history and definition of countertransference as well as empirical research on countertransference, its management, and the relation of both to psychotherapy outcome. Three meta-analyses are presented, as well as studies that illustrate findings from the meta-analyses. The first meta-analysis indicated that countertransference reactions are related inversely and modestly to psychotherapy outcomes (overall weighted effect r = ?.16, p = .002, 95% CI [?.26, ?.06], k = 10 studies, N = 769 participants). The second meta-analysis suggested that countertransference management factors that have been studied to date play little to no role in actually attenuating countertransference reactions (r = ?.14, p = .10, 95% CI [?.30, .03], k = 11 studies, N = 1065 participants). However, the final meta-analysis revealed that managing countertransference successfully is related to better therapy outcomes (r = .56, p = .000, 95% CI [.40, .73], k = 7 studies, N = 478 participants). We conclude by summarizing the limitations of the research base and highlighting the therapeutic practices predicated on research. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

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)     

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)     

Significance of posture and position in the communication of attitude and status relationships.

Attempts to present a review of the experimental findings dealing with the posture and position of a communicator relative to his attitude and status to his addressee. More studies are available which exhibit the detailed functional relationships of posture and position variables to communicator attitudes than to communicator-addressee relative status. Distance, eye contact, body orientation, arms-akimbo position, and trunk relaxation have been found most consistently to be indicators of communicator attitude toward an addressee. These variables along with the degree of arm openness of female communicators and degree of asymmetry in the arrangement of arms and legs have been found or hypothesized to be associated with status relationships with the addressee. (55 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Primative anxiety and countertransference engagement.

Psychoanalytic theorists have described primitive anxieties, including disintegrative fears about annihilation, identity loss, and the emergence of psychosis, as a foundation for borderline and psychotic mental states. These destabilizing anxieties occur across the dimensional spectrum of health and psychopathology. Openness to participatory countertransference involves both analyst and patient in primitive anxieties through their diminished psychic boundaries and their immersion in each other's internal world. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group phases and induced countertransference.

Countertransference reactions are a rich source of clinical data. The present author contends that there is a potential for developing normative data relating countertransference patterns to distinguishable stages or phases in the course of a dynamic psychotherapeutic experience. It is concluded that identifying classes of therapist reactions, and refining them for individual therapists, will enhance the depth of dynamic group psychotherapy. Case illustrations are presented to support this contention. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Supraventricular tachycardias: therapeutic attitude in 1998

Nitric oxide (NO) is believed to be identical to endothelium-dependent-relaxing-factor, a potent vasodilator. In addition, NO has been founded to play a critical role in the maintenance of vascular permeability through its attenuation of polymorphonuclear neutrophils (PMN) and platelets. In the present study, we have evaluated the effects of inhaled NO at reperfusion in canine left single-lung allotransplantation from a non-heart-beating donor. Twelve weight-matched pairs of adult mongrel dogs were used. The donor dogs were sacrificed by an intravenous injection of potassium chloride without heparinization. They were left at room temperature for 3 hours. Then, the recipient dogs received a left single-lung allotransplantation. After implantation, the right bronchus and pulmonary artery were ligated. In Group 1 (n = 6), NO gas was administered continuously at a concentration of 40 parts per million throughout a 6-hour assessment period. In Group 2 (n = 6), nitrogen gas was administered in the same manner as NO, for control. The survival time in Group 1 was significantly longer than that in Group 2. The arterial oxygen tension in Group 1 was significantly higher than that in Group 2. The pulmonary vascular resistance was significantly lower in Group 1 than in Group 2. The aortic pressure and the cardiac output each did not differ significantly between the two groups. Myeloperoxidase activity was significantly lower in Group 1 than in Group 2. Inhaled NO at reperfusion is beneficial in lung transplantation from non-heart-beating donors because it attenuates ischemia-reperfusion injury by inhibiting PMN activation and vasodilating pulmonary vasculature.     

Role expectations and symmetrical/complementary therapeutic relationships.

Rated 25 tape recorded initial therapy interviews taken from graduate and undergraduate students on the process variable of topic determination, which was indicative of the type of relationship (either complementary or symmetrical) between client and therapist. Topic determination was defined as the ratio of successful topic changes to topic change initiations. It was hypothesized that matched client–therapist role expectations would be related to a complementary relationship, as determined by a high degree of topic determination. Conversely, nonmatched client–therapist role expectations would be related to a symmetrical relationship, as determined by a low degree of topic determination. It is concluded that matched/nonmatched client–therapist role expectations are important variables in determining whether the subsequent therapeutic relationship will be complementary or symmetrical. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self and object in countertransference

We investigated the cloning efficiency, DNA repair, and the rate of DNA replication in the skin fibroblasts from patients with Werner's syndrome (WS) of an autosomal recessive premature aging disease. Five WS strains exhibited normal levels of sensitivity toward X-ray and UV killings and repair of X-ray induced single strand breaks of DNA (rejoining) and UV damage to DNA (unscheduled DNA synthesis). The sedimentation of newly synthesizing DNA in alkaline sucrose gradients demonstrated a characteristic feature that only the elongation rate of DNA chains, estimated by the molecular weight increase, was significantly slower during early passages in WS cells than in normal Hayflick Phase II fibroblasts. In addition, plating efficiencies as well as the replicative potentials of five WS strains were more limited than those of normal cells under the identical culture conditions. It seems therefore that at least in the WS cells tested, the slow rate of DNA replication may be more related to the shortened lifespan and enhanced cell death, as manifestation of premature senescence at the cellular level, than be the DNA repair ability.     

Love and hate in the countertransference supervisory concerns.

Addresses common misunderstandings of countertransference love and hate based on work with 15 therapists who engaged in sex with patients. Almost all of these cases involved some misunderstanding of love and/or hate in the countertransference. Training for most therapists fails to address these misunderstandings. Common misunderstandings involve (1) the tendency to confuse countertransference love with the positive and warm feelings associated with the therapeutic alliance, (2) therapists' need of a positive view of themselves, and (3) the tendency to view countertransference love as synonymous with empathy. Some misunderstandings may have dynamic origins and serve to rationalize the emergence of what the therapist believes to be countertransference love, but which is actually more a manifestation of countertransference hate. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Milieu countertransference in treatment of borderline patients.

Describes milieu countertransference as a collective phenomenon in which the treatment staff as a group experiences regressions in functioning that, because of the operation of the patient's ego defenses, essentially mirror the level of functioning in the patient. When properly identified and treated, the milieu countertransference can benefit treatment both as a means to better understand the patient's experience and as a tool for active intervention in remediation of the patient's pathological development. A case report, involving a 14-yr-old male, is presented to illustrate the issues and interventions involved in the milieu countertransference developed in the treatment of a borderline patient. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some factors affecting the quality of therapeutic relationships.

The degree to which the quality of the therapeutic relationship established by two equally "expert" therapists with the same patient sample varies in terms of the therapist's personality and his perceptions of the patients is investigated. "It was found that the therapist who was able to establish the better social relationships also established the better therapeutic relationships. Moreover the therapist who perceived a patient as more closely approximating his 'ideal patient' concept created the better relationship with that patient." 21 references. (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.     

Professional norms as group countertransference enactments.

Examines the danger of inadvertent professional-group self-protection (countertransference resistance) within even the most liberal countertransferential approaches. Through the application of C. Argyris's (1985) framework for analyzing organizational communication, the question is raised as to whether rigid reliance on norms in general and on a blanket nonrevelation to the client of the therapist's issues and process in particular may contain elements of professional self-protection. The governing values of valid information, free and informed choice, and internal commitment to the choice provide a focus to help clinicians distinguish between protecting the treatment and protecting themselves. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring the working alliance in advisor–advisee relationships in graduate school.

Drawing from the working alliance literature, the authors constructed the Advisory Working Alliance Inventory (AWAI) to measure the graduate advising relationship from the student's perspective. Two hundred eighty-one counseling psychology doctoral students participated in the 1st study (79% response rate). Three factors (Rapport, Apprenticeship, and Identification-Individuation) were extracted by factor analysis. The AWAI showed very good internal consistency reliability. Scale validity was supported by positive correlations between the AWAI and measures of advisee research self-efficacy and attitudes toward research, as well as the perceived expertness, attractiveness, and trustworthiness of the advisor. Forty-one students participated in the 2nd study, in which the AWAI demonstrated excellent test-retest reliability over a 2-week interval. Implications of the advising working alliance are discussed for doctoral training and areas for future research are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring the therapist's impact on the patient's therapeutic progress.

Describes methods and concepts developed by the Mount Zion Psychotherapy Research Group for empirically evaluating the pertinence or suitability of a therapist's interventions (behaviors) to a patient's particular problems, needs, and treatment goals. Intensive studies of 2 brief pychotherapy cases are presented. In these studies, patient-initiated critical incidents (tests) were identified, the case-specific accuracy of the therapist's responses to these incidents was rated, and the impact of these interventions on subsequent patient behavior was measured. The findings indicated that these patients tended to show improvement in the therapeutic process when the therapist's interventions were in accord with their particular problems and treatment goals. The application of this method to clinically relevant studies of psychotherapy is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)