Antidepressant medication in the outpatient treatment of depression: Guide for nonmedical psychotherapists.

Contends that medication can be a valuable aid in the psychotherapy of depression. The article discusses guidelines for nonmedical therapists in the evaluation of depressed patients, with a focus on characteristics that suggest a likely candidate for drug therapy. Antidepressant medications are listed (tricyclic antidepressants, MAO inhibitors, lithium carbonate), and their usage is described. Steps in making the referral are discussed. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Guided imagery and memory: Implications for psychotherapists.

Imagery techniques involve the mental generation of perceptual experiences in the absence of external perceptual stimulation. Such techniques are used for many purposes in psychotherapy but have recently come under attack as a risky practice that may result in memory distortion or the creation of false memories. This article reviews research linking imagery with changes in memory, both to sensitize clinicians to possible inappropriate applications of guided imagery techniques and to discourage researchers from understating the potential utility of guided imagery. The implications of this research for the psychotherapeutic use of imagery are discussed, and strategies for using imagery while reducing the potential for memory distortion are described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive symptom differences in hospitalized, medically ill, depressed psychiatric inpatients and nonmedical controls.

This study compared depressive and anxious symptoms in chronic medically ill individuals and depressed psychiatric inpatients using conceptually based standardized measures of cognitions and symptoms. Seventy-five hospitalized medical patients, 52 depressed psychiatric inpatients, and 25 normal controls were assessed with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987), the Mood and Anxiety Symptom Questionnaire, Hamilton Rating Scales of Anxiety and Depression, Hospital Anxiety and Depression Scales, Beck Depression Inventory, Cognitions Checklist, and Hopelessness Scale. Analysis revealed that depression in medical patients was best distinguished by symptoms of anhedonia, low positive affect, and physiological hyperarousal, whereas syndromal depression in psychiatric inpatients was specifically characterized by negative cognition symptoms. Implications are discussed for assessing depression in medically ill populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists as psychotherapists.

Comments on K. Humphreys's paper (see record 83-28417) on clinical psychologists as psychotherapists. L. R. Lieberman agrees with Humphreys that psychiatrists have abandoned doing psychotherapy but contends that it is not a good idea for psychologists to turn the practice of therapy over to those without the breadth of training implied by the Boulder model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Religiosity of psychotherapists: A national survey.

Explored the religiosity of 425 marriage and family therapists, clinical social workers, psychiatrists, and clinical psychologists. Although 80% of the Ss indicated a religious preference, only 41% regularly attended religious services. According to the Religious Orientation Inventory, 230 of 425 Ss were classified as religious. This is consistent with findings of previous studies (e.g., A. E. Bergin; see record 1980-05877-001). The potential for change toward greater empathy for religious clients is underscored by the significant levels of unexpressed religiosity found among mental health professionals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicide among psychotherapists: Review and discussion.

Comments on an article by C. Turkington (1984) that chronicles the psychology profession's attempts to provide assistance to psychologists suffering emotional distress. A review of the literature reveals the critical need for further research concerning the incidence and cause of suicide among psychotherapists (including psychiatrists). It is concluded that studies examining the rate of suicide among those who actually practice psychotherapy are needed to determine whether there is cause for alarm. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Viewing ambivalence from a sociological perspective: Implications for psychotherapists.

Ambivalence refers to the experience of simultaneous positive and negative affect toward the same person, object, or behavior that draws us in opposite directions and leads to some level of phenomenological discomfort. In psychology, ambivalence traditionally has been viewed as arising from intrapersonal conflict, that is conflict between dissonant cognitions or divided aspects of the self. Although reasonable, this explanation overlooks a larger factor. In sociology, ambivalence has been viewed as arising at the level of social structure when an individual in a particular social relation experiences contradictory demands or norms that cannot be simultaneously expressed in behavior. Sociologists have suggested that various structural attributes of the professional relationship itself can engender ambivalence on the part of clients. The present article reviews four of these structural attributes as they pertain to the client–therapist relationship and outlines a number of strategies that clinicians can employ to ameliorate the adverse effects of the sociological ambivalence that can result. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Confidential communications of psychotherapists.

Examined laws in the 50 states of the US and the District of Columbia that pertain to the protection and limitations to confidentiality outside of the courtroom. It was found that many state laws do not address a variety of issues relevant to psychotherapist confidentiality, and where they do, the positions taken are often inconsistent across jurisdictions. A comparison of the laws with concerns expressed by psychotherapists and legal scholars disclosed numerous incongruencies on a variety of issues. It is concluded that the American Psychological Association should develop a policy for each issue raised that best reflects the values of the profession. (82 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learning arenas for professional development: Retrospective accounts of senior psychotherapists.

What can senior practitioners teach other practitioners about learning arenas for professional development? Four primary learning arenas were identified after a qualitative inquiry of 12 psychotherapists, averaging 74 years in age. The 4 learning arenas are early life experience, cumulative professional experience, interaction with professional elders, and experiences in adult personal life. The results indicate that profound experiences in any of these primary arenas can radically affect the professional work of the practitioner. To develop optimally, the practitioner needs to continually process and reflect on experiences in both personal and professional life domains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

First pregnancy: Therapeutic issues for both female and male psychotherapists.

Discusses the reactions of psychotherapy clients to their therapist's 1st pregnancy, including the stimulation of unresolved oedipal and early developmental conflicts, fear of rejection and abandonment, and separation anxiety. Intensification of a maternal transference, sexual identity issues, and maternal loss and deprivation issues, along with hostile fantasies toward the unborn child and envy of the therapist as a mother and a sexual and fertile person, may arise. The reactions of the female therapist to her pregnancy may include emotional changes related to hormonal fluctuations, fatigue, and a growing sense of physical vulnerability; distraction due to the kicking of the fetus; and reduced functioning as a therapist due to feelings of fear, anger, guilt, and confusion over leaving her patients. Despite the paucity of research into the impact of impending parenthood on male therapists, it is suggested that they may experience many of the same role changes and conflicts, emotions, and reactions experienced by female therapists. Two case vignettes are presented to illustrate patient and therapist reactions to pregnancy, and suggestions to help both therapists and clients prepare to deal with issues surrounding the pregnancy are offered. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training novice psychotherapists: Helping skills and beyond.

We provide a rationale for doing helping skills training with novice psychotherapists, present a basic framework for our ideas, outline the major components of training, and then talk about what comes after helping skills training. We provide hypotheses that can be tested to determine the effectiveness of helping skills training for novice psychotherapists and encourage researchers to do more research in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging, mental health, and demographic change: Challenges for psychotherapists.

People are living longer, and in better health, than in any prior point in history, with far-reaching but as yet underrecognized implications for mental health professionals. This phenomenon affects both the developed and the developing world. With greater numbers of older people, mental health professionals will need to develop greater awareness, understanding, and appreciation of gerontology to deliver optimally effective psychotherapy with this population. The nature of psychological issues encountered in clinical practice will also change—for example, intergenerational issues among blended families, increased retirement and leisure time, and expectations of greater health and productivity in later life from baby boomer cohorts. These issues are important for mental health professionals to recognize, as the increased sophistication of the baby boomer generation in terms of health care will lead to higher expectations of mental health care. The authors have chosen to discuss the implications of an ageing population with reference to a cognitive–behavioral perspective, but the issues raised here and practical suggestions contained within this article are not restricted to practitioners of Cognitive–Behavior Therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of culturally sensitive psychotherapists.

Proposes a developmental model to describe how student-therapists learn to appropriately consider cultural factors in their clinical work with culturally diverse clients. The model is derived from discussions held in a seminar concerning mental health services and culture and from students' written accounts of how they considered cultural factors in providing therapy. Vignettes based on the written accounts are presented to illustrate the key developmental processes hypothesized to underlie psychotherapists' growing cultural sensitivity. The proposed model is contrasted with past models of therapist development. A research agenda guided by a social cognitive perspective is offered to test the proposed model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preferences toward Mexican-American and Anglo-American psychotherapists.

94 Mexican-American and 93 Anglo-American community college students listened to 1 of 2 matched therapy audiotapes. Using the same dialogue, in one tape the therapist spoke fluent English with a slight Spanish accent; in the other tape he spoke fluent English with a standard American accent. The therapist was identified as being either a Mexican-American or Anglo-American professional or nonprofessional. Both ethnic groups attributed more skill, understanding, trustworthiness, and attractiveness to the Anglo-American professional and the Mexican-American nonprofessional. The Mexican-American professional was seen by both groups less favorably than was the Mexican-American nonprofessional. Mexican-Americans showed a more favorable attitude toward the usefulness of therapy than did Anglo-Americans. Implications for the delivery of psychological services to Mexican-Americans and other minorities are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Report of conference on an ideal training program for psychotherapists.

32 representatives of the fields of clinical psychology, social work, psychiatry, and psychoanalysis discussed a set of 14 working papers. The 3 principal preparations for psychotherapeutic practice today are psychiatric residency, doctoral and postdoctoral programs in clinical psychology, and social work school, plus supervised work in a social work agency. Each has valuable contributions to make. Several types of pilot plans for improved training were proposed as being worth trying. Several kinds of potential institutional settings for such programs were considered. Regarding curriculum, "there was unanimous agreement that supervised experience in doing psychotherapy was of primary importance." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Temporomandibular disorders: Evidence for significant overlap with psychopathology.

Data were analyzed for 277 acute and chronic temporomandibular disorder (TMD) patients to determine if there was a relationship between psychological and physical diagnoses. A significant (p?     

Sexual intimacy between psychotherapists and patients.

318 psychologists provided information on 559 patients returning to therapy after having become involved in sexually intimate behavior with a former therapist. 90% of the patients reported ill effects, which ranged from difficulty trusting a new therapist to committing suicide, that could be traced to therapist behaviors that extended from intercourse to merely proposing sexual relations. Sexual contact was especially disruptive if it began early in the relationship (the majority of cases) and if it had been initiated by the therapist (also the majority of cases). The harmfulness of sexual contact in therapy validates ethics codes of the mental health professions prohibiting such conduct and provides a rationale for enacting legislation proscribing sexual contact between psychotherapists and patients. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-reported sources of stress among psychotherapists.

264 therapists from a state in the midwestern US were surveyed to (1) confirm and clarify sources of stress for psychotherapists that originate in client sessions and the professional role and (2) explore certain irrational beliefs that therapists may hold and that may contribute to their own stress. Ss were asked to complete a questionnaire that assessed background information and therapist beliefs and that contained a 36-item therapist stress scale. Irrational beliefs (e.g., that one should operate at peak efficiency and competence with all clients at all times) are examined. Suicidal ideation, aggression/hostility, premature terminating, agitated anxiety, and apathy/depression were held to be the most stressful client behaviors, while crying, absence of gratitude, and negative community stereotypes were the least stressful. Group differences in stress are described, and implications for training programs and for more refined research endeavors are discussed. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Countertransference temptation and the use of self of self-disclosure by psychotherapists in training: A discussion for beginning psychotherapists and their supervisors.

Most recent articles on self-disclosure have addressed advanced questions of theory and technique related to self-disclosure in psychoanalysis. This article, however, takes up issues related to the use of self-disclosure by psychotherapists in training. Rather than arguing categorically that beginning psychotherapists should or should not use self-disclosure, the focus here is on the factors influencing the decision of whether or not to make a self-disclosure. Illustrated by 2 case examples, it is argued that because of their relative lack of experience in working with transference and countertransference, beginning therapists are especially susceptible to the temptation to use self-disclosure and nondisclosure to close off--rather than to analyze--a patient's intense transference feelings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)