Morita therapy: Its basic features and cognitive intervention for anxiety treatment.

Describes Morita therapy as being centered around positive reinterpretation of anxiety in order to stimulate attentional, attitudinal, and behavioral change in self-preoccupied anxious clients. It promotes clients' behavioral commitment to constructive and productive activities. The shinkeishitsusho disposition is regarded as a combination of predispositional nervousness and hypersensitivity and learned and habituated cognitive patterns of anxious self-preoccupation. The aim of the therapy is not to reject the nervous disposition but to modify clients' dysfunctional cognitive and behavioral patterns to reduce unproductive self-preoccupation. The therapy promotes clients' acceptance of their predispositional nervous sensitivity and anxiousness, not as personal weaknesses but as potentially functional and constructive qualities as they are redirected toward concrete tasks and realistic action-taking. Therapeutic progress is thus initiated when clients take a positive view of their previously rejected nervous dispositions and successfully apply it to practical activities for productive purposes. Similarities and differences between Morita therapy and rational-emotive therapy are noted. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An exploratory examination of the sexual intervention self-efficacy of clinical psychology graduate students.

The current study investigated clinical psychology graduate students' self-efficacy regarding addressing clients' sexual concerns and problems. Students with more sexually liberal attitudes had higher self-efficacy beliefs. Sexuality-specific training experiences but not sexual attitudes or anxiety predicted the amount of sex therapy experience gained during graduate school. Students with more didactic education related to sexuality, more sex therapy experience, and more experience observing a clinician conducting sex therapy, had stronger sexual intervention self-efficacy beliefs. These educational experiences contributed to students' self-efficacy over and above general psychology training. The results speak to the importance of direct training to deal with clients' sexual concerns. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttherapy congruence on client symptoms and therapy outcome.

Examined whether therapists' accuracy on the level of clients' symptoms as perceived by the client (congruence of perception) was related to outcome in the cases of 50 adult clients. Clients completed a 90-item symptom check list, which was scaled on 9 symptom dimensions (e.g., depression, anxiety, hostility) and a global pathology index. Therapists rated clients directly on these dimensions. As hypothesized, posttherapy congruence correlated significantly with both client-rated and therapist-rated outcome. Congruence of perception at the beginning of therapy was unrelated to outcome. Better congruence was associated more with successful outcome than was either therapists' or clients' components of the congruence level. Findings suggest that therapists' posttherapy conceptual congruence of client functioning is highly associated with successful outcome. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of videotaped preparation information on expectations, anxiety, and psychotherapy outcome.

Examined whether preparation decreases clients' state anxiety and improves therapy outcome and clarified the relations among preparation, expectations, and state anxiety. Ss were 138 adults referred for outpatient psychotherapy. Half of the Ss viewed an 11-min preparatory videotape, while the control group waited an equivalent period before their 1st appointment. Pre–post measures confirmed that Ss who viewed the videotape had more accurate expectations about psychotherapy and lower levels of state anxiety than the control Ss. However, at 2-mo follow-up, the prepared group had significantly better outcomes on only 1 of 10 outcome measures. It is suggested that more powerful designs may be necessary to detect long-term effects of preparation and that the short-term benefits demonstrated warrant further study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client and therapist variability in clients' perceptions of their therapists' multicultural competencies.

This study examined therapist differences in their clients' ratings of their therapists' multicultural competencies (MCCs) as well as tested whether therapists' who were rated as exhibiting more MCCs also had clients who had better therapy outcomes (N = 143 clients and 31 therapists). All clients completed at least 3 sessions. Results demonstrated that therapists accounted for less than 1% of the variance in their clients' Cross-Cultural Counseling Inventory–Revised (CCCI-R; T. D. LaFromboise, H. L. K. Coleman, & A. Hernandez, 1991) scores, suggesting that therapists did not differ in terms of how clients rated their MCCs. Therapists accounted for approximately 8.5% of the variance in therapy outcomes. For each therapist, their clients' CCCI-R scores were aggregated to provide an estimate of therapists' MCCs. Therapists' MCCs, based on aggregate CCCI-R scores, did not account for the variability in therapy outcomes that were attributed to them. Additionally, clients' race/ethnicity, therapists' race/ethnicity, or the interaction of clients'–therapists' race/ethnicity were not significantly associated with clients' perceptions of their therapists' MCCs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting the Differential Effectiveness of Relaxation Training With the Multimodal Structural Profile Inventory.

Seventy-eight individuals were assessed with the Multimodal Structural Profile Inventory (Multimodal SPI) and subsequently treated with 4 different forms of relaxation training in a group format. Treatments were presented to the different clients in counterbalanced order. After each session of training, levels of anxiety were assessed with the State-Trait Anxiety Inventory. Following the completion of all sessions of treatment, clients were asked to rank order the different forms of therapy for preference. Analyses indicated that it is possible to predict which forms of treatment are likely to be most effective and preferred, on the basis of clients' scores on the Multimodal SPI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Thinking about thinking in therapy: An examination of clients' understanding of their therapists' intentions.

Two therapists each provided 2 clients time-limited (10 sessions each) therapies. These were examined to discover relations between (a) clients' understanding of therapists' intentions and episode level outcome, (b) similarities and differences between the participants' valuing of different intentions, and (c) shifts in intentions valued from the beginning to the terminal phases of therapy. By using therapists' segmentation of sessions into episodes and a computerized Counselor Intention List, some positive relations between clients' understanding of counselor intention and episode impact were documented. Differences were found between therapists' and clients' valued intentions as were systematic shifts on valued intentions from beginning to end phases of therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client retrospective recall of resolved and unresolved misunderstanding events.

Client retrospective recall of major misunderstanding events was studied in 19 cases of therapy. A qualitative methodology was used to describe the sequence of 11 resolved and 8 unresolved misunderstanding events. Results indicate that a good relationship, clients' willingness to assert negative feelings about being misunderstood, and therapists' facilitation of a mutual repair effort through maintaining a flexible and accepting stance typically led to resolution. In contrast, a poor relationship, therapists' unwillingness to discuss or accept clients' assertion of negative reactions to being misunderstood, or therapists' lack of awareness of clients' negative feelings led to unresolved misunderstandings and often to clients quitting therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multimodal Integrative Cognitive Stimulating Group Therapy: Moving Beyond the Reduction of Psychopathology in Schizophrenia.

The authors present a group therapy for schizophrenia called multimodal integrative cognitive stimulating group therapy (MICST). MICST is founded upon a theoretical model that views schizophrenia as a condition characterized by information-processing and memory deficits, which interfere with communication. MICST is designed to stimulate clients' cognitive and memory functioning, improve information processing, and enhance clients' abilities to engage in reality-based conversations. The therapy combines elements of social skills relaxation exercise, cognitive rehabilitation, and traditional psychotherapy but also emphasizes accessing clients' "intact" cognitive functioning by using both visual and auditory modalities. MICST's long-term use, its eager acceptance by clients and staff, and results from various outcome measures support its potential value. However, formal studies are required to more firmly establish MICST's efficacy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rights of clients, responsibilities of therapists.

Discusses ways in which ethical principles can be put into practice in the client–therapist relationship. Historically, ethical codes for therapists were drawn up to protect the professions from regulation by external agencies. Implicit in the ethical codes, however, is a model for the client–therapist relationship that fosters the goals of mental health. It is suggested that just as ethical codes have been given specific content in standards for providers of psychological services in human service facilities, ethical codes can be given specific content in the client–therapist relationship. It is recommended that therapists take responsibility for incorporating ethical standards into their practices so that clients' rights will be an integral part of therapy. Four illustrative situations are presented: providing clients with information to make informed decisions about therapy, using contracts in therapy, responding to clients' challenges to therapists' competence, and handling clients' complaints. (63 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients' internal representations of their therapists.

Thirteen adults in long-term individual psychotherapy were interviewed regarding their internal representations (defined as bringing to awareness the internalized "image") of their therapists. Results indicated that in the context of a good therapeutic relationship, clients' internal representations combined auditory, visual, and kinesthetic (i.e., felt presence) modalities; were triggered when clients thought about past or future sessions, or when distressed; occurred in diverse locations; and varied in frequency, duration, and intensity. Clients felt positively about their representations and used them to introspect or influence therapy within sessions, beyond sessions, or both. The frequency of, comfort with, and use of clients' internal representations increased over the course of therapy, and the representations benefited the therapy and therapeutic relationship. Therapists tended not to take a deliberate role in creating clients' internal representations, and few clients discussed their internal representations with their therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ambiguity tolerance of therapists and process changes of their clients.

Investigated the relationships between 18 student-therapists' tolerance for ambiguity in visual perception tasks and (a) the positive affect displayed toward them by their 22 student clients, (b) changes in proportions of clients' self-reference statements, and (c) measures of improvement in clients' "adjustment." Results show an increase in clients' positive affect toward the therapists but no relationship between changes in clients' affect toward their therapists or the number of their self-reference statements and the therapists' tolerance for ambiguity. Clients of ambiguity-tolerant therapists described themselves more negatively, but all but 2 clients described themselves more favorably later in therapy. No positive correlation was obtained between client and therapist affect toward each other. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of a client pretherapy orientation videotape.

Examined the effects of a videotaped psychotherapy orientation on clients' response to therapy, knowledge about therapy, utilization of services, and satisfaction with services and on therapist ratings of client attractiveness. 62 psychotherapy clients (mean age 29 yrs) at an urban community mental health center were randomly assigned to an oriented group, which viewed a pretherapy orientation videotape at admission, or to a control group. 14 therapists participated. The 11-min videotape described the relationship between client and therapist, encouraged clients to attend appointments, and stated that, although progress is rarely immediate, most clients find that therapy can lead to a reduction in anxiety and depression. Clients and therapists completed questionnaire and rating scales at intake and at 1-mo follow-up. It was found that oriented clients were able to understand and recall the information in the videotape, and the oriented group showed a greater decrease in self-reported symptoms than the control group after 1 mo. Client feedback regarding the videotape was favorable. In general, the 2 groups did not differ in their satisfaction with services, service utilization, or therapist ratings of client symptoms and functioning. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of gender, supervision, and presenting problems on practicum students' preference for interpersonal power bases.

Tested whether 102 practicum students' preferences for the legitimate, expert, and referent power bases were affected by clients' gender, the amount of students' supervised experience, and the nature of the clients' presenting problems. 64 women and 38 men from 16 counseling and counseling psychology programs completed a questionnaire in which they were asked to estimate the utility of responses reflecting each of the 3 power bases in facilitating behavior change in client's presenting problems of either depression or anxiety. Results indicate that Ss with less supervised experience preferred the legitimate and referent power bases to a greater extent than did Ss with relatively more supervised experience. Neither gender nor type of presenting problem affected Ss' preferences. Results are discussed in terms of the relation between the levels of supervised experience and the stereotypic notions of the counselor's role. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Client experience of psychodynamic psychotherapy for bulimia nervosa: An interview study.

We examined 14 bulimic clients' experiences of individual psychodynamic psychotherapy through semistructured interviews, which were analyzed using qualitative methods. The results showed that the psychodynamic approach was a challenge to most of the clients. Yet, most clients profited from therapy both symptomatically and with regard to interpersonal relations and affect regulation. There were, however, marked differences in the clients' experiences. One subgroup rather quickly felt that the therapy met their needs, another initially felt challenged by the approach and the therapeutic attitude but ultimately succeeded in using this particular kind of therapy. A third group remained predominantly critical of their therapies. The clinical implications and possible explanations of the results are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients' emotional processing in psychotherapy: A comparison between cognitive-behavioral and process-experiential therapies.

The authors compared clients' emotional processing in good and bad outcome cases in cognitive behavioral therapy (CBT) and process-experiential therapy (PET) and investigated whether clients' emotional processing increases over the course of therapy. Twenty minutes from each of 3 sessions from 40 clients were rated on the Experiencing Scale. A 2 × 2 × 3 analysis of variance showed a significant difference between outcome and therapy groups, with clients in the good outcome and PET groups showing significantly higher levels of emotional processing than those in the poor outcome and CBT groups, respectively. Clients' level of emotional processing significantly increased from the beginning to the midpoint of therapy. The results indicate that CBT clients are more distant and disengaged from their emotional experience than clients in PET. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between clients' perceptions of therapist–parent similarity with respect to empathy, regard, and unconditionality and therapists' rating of client transference.

The authors studied the similarity between clients' perceptions of their therapists and their perceptions of their parents (or early parental figures) in terms of the relationship qualities of empathy, positive regard, and unconditionality of regard and how those perceptions compared with their therapists' ratings of transference. Participants were 62 actual therapy dyads. The results failed to support a hypothesized positive association between the similarity of the therapist and parents or parental figures on the relationship dimensions of empathy, regard, and unconditionality and therapist ratings of transference. Instead, the clients' relationship ratings of their parents and therapists suggested that therapists' perceptions of transference may more accurately reflect perceptions of their clients' nontransferential (i.e., real relationship) reactions to the therapist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clients', therapists', and judges' evaluations of psychotherapy.

Asked 41 patients and their 17 therapists to complete a questionnaire indicating problem areas and their severity before and after the 1st and last therapy session. 2 clinical psychologists served as independent judges rating the client questionnaires. The clients' evaluations were unrelated to their therapists' evaluations, but were highly related to the evaluations made by independent judges. Further analyses suggest that the disagreements between clients and therapists stemmed from the therapists' inaccuracy in perceiving the clients' problems and the therapists' tendency to overestimate the progress of therapy relative to clients and independent judges. The results and the broader issue of client-therapist disagreements are discussed in terms of the client as a "consumer." (l6 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment implications of psychological assessment.

Presents some conceptual foundations and methods of enhancing the power of treatment decisions through psychological assessment. Individual articles discuss the identification of clients' behavior problems, a constructional approach to treatment, goal-centered and contextual assessment, the assessment of causal factors affecting clients' behavior problems, and the evaluation and refinement of ongoing therapy. The series proposes that treatment programs will be more effective if based on psychological assessment data and time-series assessment strategies, implemented throughout the assessment-treatment process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)