Video-tape role induction for psychotherapy: Moving forward.

Role induction (RI) has been shown to decrease premature termination and to enhance the therapeutic alliance and symptom relief. We examine the effects of a video-tape RI on premature termination rates, outcome, and the process variable of therapeutic alliance. Sixty-eight clients and their therapists (N = 26) participated in the study. Each client completed baseline measures of symptom status before beginning the therapy. Clients were then randomly assigned to either a video-tape RI condition or a no videotape treatment-as-usual condition. After the first session of therapy, clients and therapists separately completed outcome and alliance measures. Providing a video-tape RI to clients as they entered therapy did not lead to better results in attendance, outcome, or process variables. Considering possibilities that lie beyond the design of this study, so as to understand these results, is encouraged in an effort to advance the field's thinking about RI and how it can best be harnessed for continued positive effects moving forward. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Patients' representations of psychotherapy: A new focus for psychodynamic research.

Presents a psychodynamic framework and research methods for investigating the significance of patients' internal representations of therapy-with-their-therapists. In this article, 2 instruments developed for this purpose (Therapist Representation Inventory and Intersession Experience Questionnaire) are introduced, and their psychometric characteristics are described. Also, findings from a series of studies conducted with these instruments are summarized. Finally, the types of questions these instruments appear to be well suited to are proposed for addressing in future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adjunctive psychotherapy for bipolar disorder: Effects of changing treatment modality.

In a randomized, controlled trial, the authors studied an adjunctive, individual psychotherapy, interpersonal and social rhythm therapy (IPSRT) for bipolar disorder. After stabilizing participants with episode appropriate pharmacotherapy and either IPSRT or intensive clinical management (CM), participants were reassigned to IPSRT or CM in conjunction with pharmacotherapy for 2 years of preventative treatment. Early results (n?=?82) suggest that altering participants' treatment assignment at entry to the preventative phase is related to risk of recurrence. Participants remaining in the same treatment for both acute and preventative phases had lower rates of recurrence (40%) and levels of symptomatology over the subsequent 52 weeks than those reassigned to the alternate modality. This finding, consistent with the authors' philosophy that bipolar patients benefit from stable routines, suggests that disruptions in the psychosocial treatment plan contribute to worse outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patients' view of the alliance in psychotherapy: Exploratory factor analysis of three alliance measures.

Extending a previous study (R. L. Hatcher, A. Barends, J. Hansell, & M. J. Gutfreund; see record 1995-44524-001), factor analysis of 3 alliance measures completed by 231 patients explored patients' views of the alliance. Two of 6 factors, Confident Collaboration and Idealized Relationship (with the substantial general factor removed), correlated with patients' estimate of improvement (rs?=?.37 and –.23, respectively; p?     

The changing nature of hope: Development, psychotherapy, and life-threatening illness.

During the course of our work we are sometimes invited to accompany patients on journeys that affect us very deeply. It may be because they invite us to help them develop, or because they persevere in the face of extreme suffering, or because they share extreme joys and accomplishments, or because they share profound disappointment, or because they show us the power of the human spirit and the changing nature of hope. This paper describes a psychotherapy case that touched me for all these reasons. It outlines the poignant ups and downs in the journey of a young woman facing life-threatening illness. It describes the interruption and resumption of her development during emerging adulthood. It relies upon theory and research in human development, family systems, and pediatric/health psychology, and the scholarship concerning grief. The paper discusses countertransference and ethical issues as they arose during psychotherapy. I conclude with reflections on the most significant lessons I learned that have impacted my work and life going forward. Many of the issues discussed pertain not only to working with the special population facing life-threatening illness, but to working with anyone facing uncertainty, disappointment, helplessness, or loss. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Patients' reported initial reactions to abrupt disruption of psychotherapy: The aftermath of a doctors' strike.

Interviewed 20 patients (aged 19–70 yrs) whose psychotherapies were interrupted by a strike by medical doctors. Two patterns were indicated by interview data. One was characterized by initial emotional distress reaction, reactivation of previous trauma, and intensification of psychiatric symptoms. The other was characterized by relative absence of these phenomena. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual psychotherapy. Institutional psychotherapy: theoretical-practical aspect

The author describes his experience in institutional psychotherapy, at the Clínica Hospital of Villahermosa, Tabasco. He mentions factors in the patient, in the psychiatrist, in the institution and in the culture, as fostering the success or the failure of institutional psychotherapy. He shows the effectiveness of this type of treatment in this enviroment and describes ways of improving this kind of work.     

Identification of target complaints by computer interview: Evaluation of the computerized assessment system for psychotherapy evaluation and research.

We evaluated a computer interview to standardize the collection of target complaints. A total of 103 adult outpatients completed a computer interview, an unstructured intake interview, the Symptoms Checklist-90 (SCL-90), and the Minnesota Multiphasic Personality Inventory (MMPI). Results provided encouraging support for the computer interview. Clients had little difficulty completing it, and the majority described it in favorable terms. Item analyses indicated moderate internal consistency within content categories, and the majority of interview questions were significantly correlated with severity ratings of corresponding target complaints. Target complaint summary indexes were moderately correlated with overall functioning on the SCL-90 and MMPI and minimally correlated with MMPI validity scales. Individual target complaints displayed good convergent and discriminant validity with therapist ratings and self-report measures. The least positive finding was fairly low agreement between target complaints identified by clients on the computer interview and those identified by therapists. Overall, the results of this study supported the computer as a means for standardizing the assessment of target complaints. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hope-focused practices during early psychotherapy sessions: Part II: Explicit approaches.

An avalanche of research on hope over the last 30 years consistently points to the benefits of hope in living and human change processes. Common factors models name hope as one of four key factors accounting for client change across psychotherapeutic models. While research provides evidence for the importance of hope, little research examines how hope is understood and practiced. This paper, the second in a two-part series, examines hope-focused interventions of 5 hope-educated psychotherapists with 11 clients early in the therapy sequence. Two categories characterized the overall findings: implicit and explicit hope-focused interventions. The first paper in this series addressed implicit hope-focused interventions. This second paper focuses on explicit hope-focused interventions (i.e., using the word hope, hoping, etc.). Explicit use of hope in therapy was found to address: (a) multiple dimensions of hope (i.e., cognitive, behavioral, emotional, relational); (b) psychoeducational hope interventions; and (c) framing problems as threats to hope. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hope-focused practices during early psychotherapy sessions: Part I: Implicit approaches.

Hope is recognized as one of four key factors contributing to psychotherapeutic change across a variety theoretical approaches (Hubble, Duncan, & Miller, 1999), especially early in the psychotherapeutic sequence. To date little research has looked at how hope is translated into specific practices by psychotherapists during psychotherapy sessions. This case study employed basic interpretive inquiry (Merriam, 1998) to explore the hope-focused practices of five hope-educated psychotherapists with 11 clients early in the therapy sequence. Two categories characterize the overall findings, that is, implicit and explicit hope-focused practices. This first paper in a two-part research report focuses on implicit hope-focused interventions. Implicit hope-focused interventions were those practices identified by therapists as addressing client hope without employing the word hope explicitly. Implicit hope practices addressed two key aspects of therapy, (a) attending to therapeutic relationship, and (b) fostering client perspective change. The second paper in this series examines findings regarding explicit hope-focused interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patients' rights.

Comments on T. S. Szasz's (see record 1983-05532-001) mention of slavery in proposing the idea of a "psychiatric will." The present author draws parallels between the rationale for the enslavement of Blacks and the rationale for involuntary commitment (vs patients' rights) of the mentally ill in the US. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Extinction during psychotherapy of GSR accompanying embarrassing statements.

"Statements by a therapy patient acknowledging personal sexual behavior or desires were frequently accompanied during early hours of therapy with galvanic skin responses, but not during later hours, following a progressive decline. This finding is taken as evidence that the GSR is associated with such feelings as fear or embarrassment in the interpersonal relationship with the therapist and that such feelings extinguish during therapy." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The future of psychotherapy with children: Developmental psychotherapy.

Discusses the concept of developmental psychotherapy for children as a way of integrating information about human development, basic biological processes, and psychopathology with knowledge gained from studies of therapeutic change. In developmental psychotherapy, rather than trying to provide a permanent cure, the therapist tries using a variety of methods to help the child regain a footing on a developmental pathway more likely to lead to adequate adaptation in subsequent periods of life. Research in this field should concentrate on continuing refinement of models for developmental pathways leading to specific outcomes in a number of domains, particularly those involving externalizing disorders and substance abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changing the dialogue between self voices during psychotherapy.

According to Dialogical Self Theory (DST) the self is composed of various characters, each of them portraying an aspect of an individual, and these characters, starting out from their various separate positions, enter into a dialogue and negotiate the meaning of events with each other. This theory is helpful in explaining the discourses that patients produce during psychotherapy and the way in which treatment alters the dialogical relationship between characters. Through the analysis of the clinical case of a patient, whose Self-Narratives were retraced and analyzed using the Self-Investigation method, I shall attempt to show what characters made up the patient's mental world, what type of dialogical relationship there was between them and what affect therapy had on them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Components of the psychotherapy relationship: Their interaction and unfolding during treatment.

C. J. Gelso and J. A. Carter (see record 1986-09708-001) suggested that all counseling and psychotherapy relationships, regardless of theoretical orientation, consist of 3 components: a working alliance, a transference configuration (including therapist countertransference), and a real relationship. Drawing on theoretical and research literature and using clinical examples, this article offers 19 propositions about how these 3 relationship components interact with one another, how each operates across the course of psychotherapy, and how they affect the treatment in both brief and longer term therapies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual psychotherapy. Institutional psychotherapy. Individual approach

In the psychiatric management of patients where the author works the following factors are given careful consideration: a) source of referral, b) previous information about the illness, c) the content of the first session, d) obstacles for further treatment and e) theoretical basis for the psychotherapy sessions. Bellak and Small outlines are followed to structure brief and emergency psychotherapy at the author's institution.     

Voice predicts affect during psychotherapy

This study examined the relationship between emotions and the frequency and power characteristics of the voice in psychotherapy. The intensity of fear, anger, depression, and total affect in each of four interviews with one patient was rated every 20 seconds on a nine-point scale. Significant agreement among judges was achieved. Voice samples from each epoch in which there was sufficient speech were subjected to spectral analysis of the frequencies between 0 and 1000 HZ. These spectra were scored for nine frequency and power parameters. Multiple linear regression equations were then developed from two interviews, using the nine voice spectral variables as predictors and the mean ratings for each affect as the criterion variables. Significant multiple correlations were achieved between every rated affect and various combinations of voice variables. The beta weights and constants from these equations were then employed in the successful prediction of levels of anger, fear, depression, and total affect in one interview, and the levels of depression and total affect in another interview. In addition, epochs of conflict differed from "pure" affect epochs, and pure epochs of anger, fear, and depression differed from each other in various frequency and power characteristics of the voice. Voice spectral measures may be an objective means of identifying and quantifying affect in psychotherapy.     

A prospective interpretation of unconscious processes during psychoanalytic psychotherapy.

Describes the use of the prospective approach (PA) to resolve intrapsychic conflict in a 28-yr-old woman who complained of incestuous flashbacks about events that had occurred during her childhood. The PA is a technique for interpreting the latent content of patients' narratives and dreams. It proposes that intrapsychic conflict impairs the patients' predictive abilities. The PA may be implemented during all phases of treatment to examine whether the patient is able to predict the interpersonal outcomes of imminent events. During the initial alliance phase, patients use the therapists' responses to predict upcoming change. During the working-through phase, patients rely on their own perceptions to assess future outcomes. During the termination phase, patients predict outcomes from the responses of significant others. In this case, the S resolved her ambivalence about incest allegedly perpetrated by her father through a series of powerful dreams. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Foreword: Values in psychotherapy.

Contends that the glory of psychotherapists' "tree of psychology" is that its roots are absolutely philosophical and, therefore, limitless in scope and devoid of absolute proofs. The trunk of this tree is a solid and substantial store of scientific and empirical data. The branches bear a multitude of flowers, many of which are not quite substantial; not made to endure the critical climate of a questioning world. Ultimately, however, these flowers contain the germinating factor, that which allows human knowledge the possibility of continued growth and rejuvenation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Moving toward a global psychology: Changing theories and practice to meet the needs of a changing world.

Increasingly, the United States is becoming internationalized as a result of sophisticated communication technologies that put us in touch with countries known previously to only a few, through economic development and multinational investment, and by the immigration of people who are sometimes fleeing hostile homelands. US citizens, like others abroad, will need to be responsive to the demands of a multiethnic, multiracial, and multinational society. The challenges of this changing world can and will range from such dilemmas as ethical decisions of who can and will have access to expensive technology that saves and prolongs life; to the development of conflict management strategies for peaceful coexistence with neighbors whose behaviors, beliefs, and values are strongly shaped by their religious, cultural, and ethnic backgrounds and socioeconomic circumstances. With the inauguration of this section, US psychology is invited to consider its contribution to meeting the needs of a changing society. (PsycINFO Database Record (c) 2010 APA, all rights reserved)