The psychotherapist and the managed care setting.

This study represents a beginning effort to understand how alternative health care delivery systems affect psychotherapists and psychotherapy practice style. Professionals from various mental health disciplines employed in staff-model health maintenance organizations (N?=?43) served as interviewees. Therapists answered objective and semistructured questions about their work setting, "burn-out," graduate training, and the evolution of self and practice style. Although methodological limitations prohibit meaningful and valid generalizations, the results suggest that alternative health care settings may serve as catalysts by creating an atmosphere that shapes and influences the therapist to develop more eclectic, short-term, problem-focused psychotherapy practice habits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychotherapist and one-way intimacy.

Several prominent psychotherapists have asserted that many therapists use their relationships with clients to gratify desires for controlled, "one-way" intimacy in which they are less vulnerable than the clients. The present experiment tested the hypotheses that (1) therapists have higher needs for control and intimacy than the normative population; (2) need for control is negatively related to quantity and quality of family involvement; and (3) therapists categorized as pseudo-intimate have higher need for control than those categorized as intimate. The FIRO-B and assessments of structured interviews by blind raters provided data on 26 male practicing psychotherapists (aged 29–61 yrs) and 28 male doctoral students (aged 24–48 yrs). None of the hypotheses were supported. Therapist and trainee need scores were similar, and both groups had lower needs for inclusion and needs to be influenced by others than are the norm. Roughly two-thirds of the therapists were categorized as intimate and one-third as pseudo-intimate. Results do not support the idea that therapists gratify their neurotic needs through working with clients. Implications for future research and for therapist selection and training are discussed. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pop sociology and the psychotherapist.

Suggests that G. W. Albee (see record 1977-29846-001) holds a model of a psychotherapist as one who loosens inhibitions and frees sensuality. It is suggested that psychotherapy actually attempts to integrate all impulses and realities within a value or philosophic context, not a context of hedonistic sensuality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bias in psychotherapist ratings of client transference and insight.

The psychology literature at large considers rater bias to be a substantial source of error in observer ratings. Yet, it is typically ignored by psychotherapy researchers using participant (psychotherapist/client) ratings. In particular, interrater variability, or differences between raters' overall tendency to rate others favorably or unfavorably, has been a largely ignored source of error in studies that use psychotherapists and/or clients as raters. Ignoring rater bias can have serious consequences for statistical power and for interpretation of research findings. Rater bias may be a particular problem in psychotherapy research, as psychotherapists are often asked to rate subjective variables that require much rater inference. Consequently, we examined the extent to which rater bias is a factor in psychotherapist ratings of client transference and insight, by comparing psychotherapist variance from these ratings to psychotherapist variance in ratings of client-perceived emotional intelligence, using Hierarchical Linear Modeling. Results suggest that bias may be a substantial source of error in psychotherapist process and relationship ratings, accounting for, on average, 38% of the total variance in scores, and 30% after accounting for perceived emotional intelligence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of stress on goal setting behavior.

The disorganization often induced by stress may be avoided when the organism can modify the situation, as for example, in setting a new goal after failure to reach the first goal. The performance of adolescent boys on a modified form of the Rotter Aspiration Board shows that level of aspiration varies with conditions of stress. From Psyc Abstracts 36:02:2FH80R. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The training psychotherapist in a therapeutic community.

Discusses the impact of a therapeutic community on the training psychotherapist and indicates potential difficulties in working with psychotic patients in a setting that demands personal vulnerability and that may reawaken the therapist's yearnings for communal participation and belonging. The psychotherapist may develop a communal transference as a result of his/her repressed communal object-hunger. The "mad psychotherapist" "Dr. Doctor," and the "nag therapist" characterize defensive postures taken by psychotherapists dealing with the stress of treating psychotic patients in a therapeutic community. As a result of their communal participation, therapists have the opportunity to work through this transference which then enhances their psychotherapeutic efforts. The psychotherapist further matures when toward the end of training, he/she confronts the social reality of the patients' continued hospitalization. The therapist's role in assisting the social rehabilitation of his/her patients is discussed. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

True and false self in the development of the psychotherapist.

Explored the psychotherapist's struggle to achieve a position of security, using interviews with 15 doctoral students in clinical psychology who described their experiences of learning to do psychotherapy and the development of their identities as psychotherapists. Areas of experience within the psychotherapy training context and also in Ss' personal lives were considered. During the course of their training, Ss were seen to develop self-protective competencies, which are conceptualized in terms of the theory of the true self and the false self developed by D. W. Winnicott (1965). The psychotherapist false self is linked to commonly used terms such as professional identity and identity as a psychotherapist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress-relevant deviance and sources of stress negotiation difficulties in the medical setting.

Uses theoretical formulations and findings from experimental personality research on stress and coping to evaluate common stress management techniques in the behavioral medicine domain. A distinction is made between procedures that attempt to regulate internal stress arousal (fear-control techniques) and those that focus on personal coping activity and the mobilization of environmental counter-threat resources (danger control techniques); the primary focus is on danger control techniques. A preliminary theoretical framework is advanced for considering the danger control aspects of behavioral medical interventions; this framework focuses on informational factors pertaining to the controllability of stressor events. Impediments to stress management in the behavioral medicine setting suggested by stress-relevant deficits and anomalies associated with psychopathology are also discussed. Tentative implications for improved stress management procedures in behavioral medicine are proposed. (French abstract) (56 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specialization in psychotherapy: From psychotherapist to psychooncologist.

The professional journey of a traditional psychotherapist into the specialty of psychooncology is described. The tasks of the psychooncologist in working with patients with cancer as well as the patient's parents, partner, and children are discussed. Clinical vignettes and specific psychotherapeutic interventions are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interviews as catalysts in a community setting.

Examined the effects of interviews about community experience on subsequent attitudes and behavior of adult residents in 2 new condominium communities. Volunteer (23 households) and randomly selected experimental (17 households) groups of respondents were interviewed in their homes. Questionnaires about community experience were administered shortly after the interviews (at 1 condominium) and 6 mo later (at both), and observers rated the activism of community leaders during the interim. Interviewed respondents gave less socially desirable and more extreme responses to the first questionnaire, reported more involvement in the community, and were rated more active in community affairs than uninterviewed controls (103 households). The dynamics of interviews as catalytic events are considered, and the implications of these findings for future use of interviews are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Churg-Strauss syndrome. Personal caseload and review of the literature

Churg-Strauss syndrome (CSS) is a disease characterised by hypereosinophilia and systemic vasculitis occurring in patients with asthma and allergic rhinitis. In the course of CSS three phases may be distinguished. The prodromal phase, which may persist for many years, consists of allergic disease. The second phase is characterised by peripheral blood eosinophilia and eosinophilic tissue infiltrates that produce a clinical picture diagnosed as Loeffler's syndrome, chronic eosinophilic pneumonia or eosinophilic gastroenteritis. The third phase is dominated by systemic vasculitis in which skin, cardiovascular system, gastrointestinal tract and peripheral nervous system are frequently involved. Renal disease in CSS is less common and generally less severe than that classical polyarteritis nodosa and Wegener's granulomatosis. Genitourinary tract may be involved, too. In the postvaculitic phase, allergic rhinitis and asthma usually persist and clinical picture is characterised by the consequences of the vasculitic illness, most commonly in form of neuropathy and hypertension. The pathogenesis of CSS is unknown but its association with asthma and allergic rhinitis may indicate an abnormal immune reactivity. The recently reported association with antineutrophil cytoplasmic antibodies with antimyeloperoxidase specificity may suggest a their role in the pathogenesis of the disease. An important role may be played by eosinophils, too. The main therapy is that with corticosteroids, possibly in association with immunosuppressive drugs.     

Client–psychotherapist seminars for refining theory and practice.

Recommends the establishment of regular client–therapist seminars during which therapists can discuss and refine the theoretical and operational assumptions underlying the type of psychotherapy they have adopted. Such discussions can lead to a number of concrete benefits, including the initiation of research to test the validity of theoretical assumptions. It is suggested that these seminars especially can be a boon to those psychotherapists who find their professional growth stagnating and their enthusiasm for therapy on the wane. The author's experiences in establishing and conducting client–therapist seminars are discussed and include such particulars as protecting the confidentiality of the participants. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The septuagenerian as child psychotherapist: A change in career orientation at the end of the stream.

The writer describes his experiences when, at an advanced age, he became therapist to severely disturbed, disorganized, nonverbal children. The therapeutic approaches evolved and the personality changes that occurred in him as a result of the therapeutic interchanges with his young patients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preliminary results of a video-assisted psychotherapist workshop in alliance strategies.

This study examined the preliminary results of an integrative, video-assisted training workshop aimed at helping psychotherapists build strong therapeutic relationships with their clients. Participants were 57 clinicians across five community mental health clinics, who were randomly assigned to the brief alliance-training workshop (in which they participated prior to starting treatment with a new client) or to a delayed-training control condition. Outcomes assessed included therapist-reported use of alliance strategies during Session 1, therapist-rated alliance quality after Session 1, and client engagement across the first 4 weeks. In contrast to hypotheses, one-way analyses of variance and chi-square analyses revealed no statistically significant differences between the training and the delayed-training conditions. However, the therapist-reported impact of using the workshop's alliance strategies was positively correlated with therapist-rated alliance quality (r = .30, p = .03) and marginally correlated with number of sessions attended (r = .25, p = .06) across the two conditions. The findings hold promise for the utility of a brief alliance-focused workshop, and for collaborations between researchers and clinicians seeking to bridge science and practice. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Screening for posttraumatic stress disorder in a general psychiatric outpatient setting.

Posttraumatic stress disorder (PTSD) may affect survivors of a number of accidents and illnesses, in addition to violence victims and combat veterans. Prior research suggests that PTSD may be underdiagnosed when trauma is not the presenting problem. Thus, a PTSD screening scale might have utility in routine clinical settings. The authors evaluated the screening performance of the Posttraumatic Diagnostic Scale (PDS) in a general psychiatric setting. Results indicated that the PDS performed as well in this setting as it did in the original trauma-focused validation studies, independent of PTSD status as a primary, versus secondary, reason for presenting. A simple cutoff score was adequate for case identification. There were no gender effects, and the scale performed equally well among patients with, versus without, a depressive diagnosis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Key competencies of the psychodynamic psychotherapist and how to teach them in supervision.

Four of Rodolfa et al.’s (2005) competencies in professional psychology—relationship, self-reflection, assessment-case conceptualization, and intervention—are key for the psychodynamic psychotherapist. Relationship lies at the heart of what is understood to be curative about psychodynamic psychotherapy. Self-reflection implies a complex and highly developed process that includes but goes beyond Rodolfa et al.’s and Kaslow, Dunn, and Smith’s (2008) definitions. Competent assessment, diagnosis, and case conceptualization entails making inferences about unconscious processes by observing the client and also one’s own experience, and integrating these inferences with theory. Effective psychodynamic intervention is derived from what the psychotherapist has experienced, processed, and conceptualized about the relationship with the client and about the client’s internal object world. An extended vignette shows these competencies emerging in a psychotherapist-in-training, facilitated by an intense interaction with a supervisor. Although the supervisory and clinical tasks are different, the supervisor provides a relationship experience that models these same competencies for the supervisee and catalyzes their development in the supervisee. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A legal and ethical review of patient responsibilities and psychotherapist duties.

The ethics and standards of practice literature has long focused on the duties that psychotherapists owe their patients. While this has been valuable to the profession, it has created a circumstance in which psychotherapists have focused on their duties and responsibilities to their patients with little understanding or respect for how the conduct of a patient can impact those factors. These articles will review these factors from both an ethical and legal perspective. In addition, all of the articles discuss the premise that, while the psychotherapist has the primary responsibilities when rendering treatment to a patient, the treatment alliance is actually a dynamic that changes depending upon the conduct of both the psychotherapist and the patient. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Performance and knowledge of results as determinants of goal setting.

Found that previous performance on a simple addition task exerted a significant positive impact on the goal levels set by 22 male and 58 female undergraduates. When performance effects were accounted for, knowledge of results (kr) also influenced goals significantly. When the effects of 4 forms of kr were compared, correct kr increased goal level significantly above that generated by no kr, while incomplete kr increased goal level insignificantly, and erroneous low kr decreased performance below the level associated with no kr. Implications for administrative practice and goal-setting theory are discussed. (17 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)