Review of Women as therapists.

Reviews the book, Women as therapists by Dorothy W. Canter (see record 1990-98731-001). The reviewer, although grateful to Dorothy W. Canter's Women as therapists for offering us an often skillfully executed concert that might best be called "Solo variations on some themes," felt, in reading it, the lack of integration in what at first had promised to be a richly symphonic program. The book itself is constructed along two main themes or axes: One takes as its focus the diversity of psychotherapeutic schools or approaches, and the other concerns the relevance of women's gender--primarily the gender of the therapist, though secondarily the gender of the patient--to the practice of the four approaches outlined and to the practice of psychotherapy in general. The book's title and table of contents seem to suggest that it is the latter theme, with its emphasis on the elucidation of the specific contributions of women's gender to their work as psychotherapists, that is the more overarching; the diversity of psychotherapeutic schools is reflected only in specific chapter titles, rather than in section headings. Yet the lion's share of the text is devoted to presentations of the four psychotherapeutic viewpoints end only inconsistently and briefly to accounts of the impact of the therapist's gender within the discussion of each school. The breadth of these viewpoints, taken together, was clearly meant to illustrate the range of manifestations of women's work as therapists, though in fact the gender theme is not successfully maintained in the sections devoted to clinical work. Thus, each of these two organizing principles represents a substantial force in the text, and it is the tension between the two that gives the book its distinctive, and often problematic, character. (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)     

Intersecting losses: Working with the inevitable vicissitudes in therapist and client lives.

Therapists working with clients with severe trauma histories over long periods of time may find themselves managing traumatic events in their own lives—illness, divorce, death—at the same time as they are assisting their clients to live productively with their painful pasts. While a few accounts exist describing how therapists deal with single overwhelming events, very little has been written about how therapists manage ongoing or prolonged episodes of severe stressors with a busy clinical practice of clients with severe trauma histories. Yet, we know that support for therapists is crucial to longevity in the field and we also know that learning from the experience of others is a highly recommended form of support. This paper is an account by a senior clinician of how she has maintained a productive clinical practice despite personal losses. Therapists who struggle with personal losses probably deal with choices related to self-disclosure more than therapists who do not have such experiences; they have repeated opportunities to establish appropriate and effective levels of self-disclosure for them and the people with whom they work. The paper presents a template for thinking about the risks and benefits of self-disclosure while at the same time modeling a level of self-disclosure that may be beneficial to therapists looking for examples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The first session in brief therapy.

Reviews the book, The first session in brief therapy edited by Simon H. Budman, Michael F. Hoyt, and Steven Friedman (see record 1992-98543-000). This book provides an overview of the models of brief psychotherapeutic intervention. A major focus is how brief therapists structure and manage their initial contact with the patient. The editors intend this volume to be a casebook in which the reader can learn what therapists actually do in their clinical practice and offers the reader opportunities to further develop and sharpen his/her thinking regarding brief therapy. According to the reviewer, this book provides a fine survey of the current diversity of approaches to brief therapy. Taken as a whole, the book stimulates considerable thought on the most efficacious use of time in psychotherapy and will appeal to a wide audience including graduate students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A qualitative investigation of eminent therapists' values within psychotherapy: Developing integrative principles for moment-to-moment psychotherapy practice.

Ample empirical research on values has demonstrated that clients' values tend to become increasingly like those of their therapist during therapy. There is little research, however, on how therapists negotiate value conflicts and the role of values in therapy. In order to better understand this process, 14 expert psychotherapists from four major psychotherapy orientations were interviewed about their use of values in the psychotherapeutic change process. A grounded theory analysis was conducted leading to an integrative understanding of how expert therapists from different orientations conceptualize the relationship of values and change in therapy and how they work with values in sessions. Based on this analysis, four transtheoretical principles were generated that can be applied to training and practice and used to inform research on psychotherapy process and integration. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Patient fees and psychotherapeutic transactions.

Notes that little discussion about fees has appeared in the literature on therapeutic practice, technique, or training. 3 published questionnaire studies concerning basic therapeutic procedures reveal information about therapists' orientations toward fees. While therapists generally are alert to interpret patient remarks and concerns about fees, they often are defensive and doctrinaire about their own attitudes regarding finances. Economic aspects of human interaction and of psychotherapeutic transaction partly have replaced sexual ones as areas which badly need elucidation. Questions are raised about the rationale for various financial practices, and some historical, cultural, and personal factors bearing on the economic aspects of psychotherapy suggested. 3 case examples highlight some effects of these factors on the therapy situation. (20 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tutoring, apprenticeship and the relationship between theory and practice: the open knots]

The risk of developing clinically relevant psychiatric disorders in the lifetime course is significantly greater among children of mentally ill parents. A child-adapted programme of information concerning the nature and symptomatology of parental illness is considered to be an important preventive factor, and lies within the domain of the psychiatrist's or therapist's responsibilities. During the developmental phase of a prevention project at Freiburg University's Department of Psychiatry and Psychotherapy, both clinical practice and the level of problem awareness among patients and the therapists were evaluated. Over a period of one year, consecutive interviews involving 114 patients with children under 18 years of age, as well as their respective therapists, were conducted. The results showed that: scarcely any exchanges between children and therapists took place; the extent to which children are informed about parental illness must be considered as small; a high percentage of such children are already evaluated by their parents as disturbed, and the pressing need for support exists.     

Impact of therapist pregnancy on the process of counseling and psychotherapy.

Reviewed research on the relationship between the therapeutic process and potential outcome. Research concerning the impact of a therapist's pregnancy on the psychotherapeutic process was discussed in the context of 5 components that are thought to lead to the outcome of the therapeutic process. These components included the therapeutic contract, therapeutic interventions, the therapeutic bond, the patient's self-relatedness, and therapeutic realizations. Setting clear therapeutic limitations, holding conjoint sessions in transferring clients to new therapists, and considering the role of client diagnosis are important considerations for pregnant therapists in negotiating the therapeutic contract. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapists' perceptions of stressful patient behavior.

Administered a 25-item Likert-type rating scale to a heterogeneous sample of 60 psychotherapists (mean age 38 yrs). Results indicate that Ss considered suicidal statements to be the most stressful form of patient behavior encountered in their practice. Factor analysis of the data revealed 2 general dimensions of stressful patient behavior: Psychopathological Symptoms and Resistances. The stress associated with each of these factors also varied significantly as a function of certain S background variables. A relatively high degree of stress engendered by premature termination of therapy was also found. This suggests that therapists are not simply detached observers of the psychotherapeutic process and are not likely to consider their patients as replaceable parts. Ss appeared to be personally as well as professionally invested in the emotional growth and welfare of individual patients. It is concluded that therapists must be sensitive to those particular sources of stress that affect them and the nature of the therapeutic relationship. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Addressing Diversity Issues in Play Therapy.

Globalization is upon us, resulting in almost daily exposure to and interaction with highly diverse populations. To practice ethical play therapy, play therapists must become culturally competent. Play therapists are called on both to address cultural issues in therapy and to facilitate children's pride in, and preservation of, their culture. Despite this, the existing literature on cultural competence in psychotherapy has rarely been applied to play therapy practice. The author's goal is to do just that so as to provide play therapists with a model relevant to their work. Play therapists must first fully understand the concept of culture and its potential impact on their own lives, the lives of their clients, and the play therapy process. Second, play therapists need to develop adequate levels of culturally related awareness, skills, and knowledge. Last, they can ensure the work they do is more culturally sensitive and competent by following basic guidelines. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Through a glass darkly: Reflections on therapist transformations.

Psychologists are not immune to unfortunate, potentially devastating, life-changing events. The following article explores how a shared event, the loss of a child, impacted 2 different therapists and describes their individual changes in therapeutic perspectives and approaches. Vulnerabilities and lessons of resiliency are presented, with the direct impact on psychological practice discussed. The authors conclude that encountering personal struggles or challenges can have a transforming influence on therapists, including how therapists conceptualize and interact with their clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapist's anxiety level, self-insight, and psychotherapeutic competence.

"The present study was designed to test the hypothesis that competent psychotherapists are less anxious and possess a greater degree of insight into the nature of their anxieties than do psychotherapists who are judged to be less competent." The results showed that anxious therapists were rated to be less competent than therapists low in anxiety. There were no significant relationships between the therapist's self ratings of anxiety or the degree of insight and ratings of psychotherapeutic competence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist's self-disclosure: Expanding the comfort zone.

While most therapists engage in some form of disclosure, intentional decision to share feelings and personal views with patients remain a complex area of clinical practice. This article offers parameters for the use of intentional self disclosure in the context of an ongoing relational psychotherapy. When psychologically attuned and patient centered, intentional disclosure opens space for deep therapeutic engagement between therapist and patient. It heightens self-perception, affective experience, and relational connection. Clinical vignettes are used to illustrate the intentional use of self-disclosure that opens up the possibility of deeply personal and transforming conversations between therapists and patients that advances psychotherapeutic aims. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Competency judgments in the training and evaluation of psychotherapists.

Competency or skillfulness refers to the quality of the therapist's interventions. Competency evaluations, although difficult to make, are useful in the training of psychotherapists. Several competency scales are reviewed, and most of these raise significant concerns about interrater reliability and predictive validity. It is argued that competency is best considered a state-like variable, with therapists demonstrating higher competence when they skillfully treat patients across a range of difficulty levels. Competency scales may facilitate the development of a generally accepted standard within a specific psychotherapeutic modality. For competency measures to gain practical acceptance, supervisors must accept their value for documenting replicable qualitative observations of therapists' behavior both within and across cases. The development of standards of psychotherapy practice awaits further scale development and research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Women changing therapy: New assessments, values and strategies in feminist therapy.

Reviews the book, Women changing therapy: New assessments, values and strategies in feminist therapy edited by Joan Hamerman Robbins and Rachel Josefowitz Siegel (1985). The assertion has been made that women in general, and feminist therapists in particular, have impacted on the theory, research, and practice of psychotherapy. Women Changing Therapy is a compilation of articles designed to provide evidence for this assertion. The book grew out of the participation of a number of female therapists in the Women's Institutes of the American Orthopsychiatric Association and its breadth of topic areas addresses a wide range of issues in psychotherapy. The twenty articles are loosely arranged in three thematical areas: Women's Issues: New Assessments, Valuing Our Selves, and New Strategies in Feminist Therapy. This volume is a patchwork of sorts which attempts to detail the effect women have had on the psychotherapeutic process. While it is uneven in places, its blending and contrasting sets it up as a good reference piece and/or volume for the uninitiated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The A-B scale and empathy, warmth, genuineness, and depth of self-exploration.

Studied initial interviews conducted by 25 senior medical students with 25 neurotic outpatients. There were no significant relationships between the therapists' A-B scale scores and their empathy, warmth, and genuineness. B-type therapists did elicit greater depth of exploration, a result consonant with existing research. Findings suggest that these 2 sets of variables the A-B scale and empathy, warmth, and genuineness are independent sources of variance in therapeutic outcome. The A-B scale offers the potential of leading to the discovery of a new set of determinants of psychotherapeutic success. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Policy on insurance.

Comments on the position adopted by APA in negotiating with insurance companies on the subject of reimbursement to psychologists for services rendered under health insurance plans. When outpatient psychotherapy is covered by insurance, a psychologist making an independent determination of the need for psychotherapeutic treatment is, according to the APA resolution, being a "judge of illness in the medical sense" and that the "appropriate inter-professional collaborative relationships" between medicine and psychology is for the medical person to make the determination of psychotherapeutic illness and to decide upon the need for psychological services. We are officially concurring that medicine is within its rights in determining the need for and supervising psychological services, when these services are covered by insurance. The APA position on this insurance issue contravenes previously accepted APA policy which states that, within the scope of ethical practice, a psychologist may function autonomously as a psychotherapist. This has been done without sufficient justification, and certainly without sufficient notice to and discussion by the membership. It behooves APA to defer any further negotiation on this issue until it provides for a full reconsideration of the issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)