Psychotherapy’s Philosophical Values: Insight or Absorption?

According to insight-oriented psychotherapies, the change clients undergo during therapy results from insights gained into the “true” nature of the self, which entail greater self-knowledge and self-understanding. In this paper, I question such claims through a critical examination of the epistemological and metaphysical values underlying such forms of therapy. I claim that such psychotherapeutic practices are engaged in a process that subtly “absorbs” clients into the therapist’s philosophical framework which is characterized by a certain problematic conception of subjectivity, knowledge, and reality. Through mechanisms which are intrinsic to the therapeutic encounter, such as suggestion and power, such therapies construct and reconfigure clients along the lines of socially accepted norms and values. Consequently, insight-oriented psychotherapy results in a deceptive form of social control.     

Bridging the gap between long- and short-term group psychotherapy: A viable treatment model

The purpose of this paper is to support the efficacy of short-term insight-oriented, process group psychotherapy and to present a unique treatment model. The format for a time-limited, dynamic group therapy model with the opportunity to recontract for additional segments will be discussed. Evidence will be presented that supports the effective use of this model for providing continuity of care for patients with both long- and short-term treatment goals. The referral process,contracting for appropriate goals, group development, the cotherapy relationship, and other specific treatment issues will be addressed.     

Group psychotherapy as a technique for assisting ego-impaired children and adolescents

This paper describes an approach to working with egoimpaired children and adolescents. The structure and process of psychotherapy groups within a residential program are discussed. We describe how insight-oriented groups act as a collective superego, thereby encouraging maturation. Functions of the group relating to socialization, milieu issues, peer issues, family relationships, personal issues, selfesteem, empowerment, and special issues are discussed. The focus of the discussion is on the structure and process of the groups. Brief clinical vignettes are utilized to illustrate components of the approach.     

New faces of spiritual pride

Contemporary counseling and psychotherapy, including pastoral counseling and psychotherapy, frequently claim as their domain the total person, including the spiritual dimension. Within the traditions of spiritual direction is a deep concern for the phenomenon of spiritual pride, If counseling and psychotherapy are to deal with the person's spiritual development, counselors ought to be aware of this disruptive dynamic. It is suggested that the counselor's own personhood may be a primary condition for leading to spiritual pride and that the process of termination may be a specific illustration of this phenomenon. The negative power of spiritual pride is significant in that it leads to premature closure relative to the growth process.     

Spiritual Psychotherapy for Antisocial and Psychopathic Personalities: Some Theoretical Building Blocks

Until now a profound theoretical model for spiritual psychotherapy, which is constructed specifically for nonreligious antisocial and psychopathic patients who have spiritual and philosophical interests, is missing. In this paper some important theoretical issues with respect to spiritual psychotherapy for antisocial and psychopathic patients will be discussed such as the links between spirituality on one hand and authenticity, vanity; emotional, moral, and social capacity; reality testing; creativity; and faith in life on the other. Furthermore, the spiritual psychotherapist's attitude towards his or her patients will be explored.     

Recovery,Spirituality and Psychotherapy

This article concerns the relationship between addiction recovery, spirituality and psychotherapy. Since its founding, members of AA have been encouraged to pursue a spiritual life. They have also sought psychotherapy. A paradox obtains, because 51 % of therapists are atheists. Others have little awareness of the dynamics of the spiritual life. The developmental process of the spiritual life is discussed, and suggestions are made regarding how a therapist might be helpful in this process.     

Fundamental Dilemmas in Contemporary Psychodynamic and Insight-Oriented Psychotherapy

Contemporary psychotherapists are being called on to provide treatment with increased degrees of brevity and efficacy. To meet these demands, the practice of brief psychodynamic psychotherapy has turned to (a) the increased emphasis upon a specific psychodynamic focus for treatment versus the more comprehensive goals of longer-term treatment, and (b) the augmented use of confrontation of psychological defenses versus the enhanced use of emotional support as in more nondirective psychotherapy. Other approaches to insight-oriented psychotherapy that have been influenced by this trend include: client-centered psychotherapy with its focus upon the therapeutic relationship; existential psychotherapy with its focus upon death anxiety; and, the revitalization of interpersonal psychotherapy from its original Sullivanian conceptualization. The clinical dilemmas that limitations of time and restricted therapeutic focus place upon each of these methods of treatment are the central issues of this discussion.     

An empirically-based rationale for a spiritually-integrated psychotherapy

In this paper, we offer an empirically-based rationale, for a particular kind of psychotherapy, spiritually-integrated psychotherapy. Drawing on several lines of research we note that: (1) spirituality can be a part of the solution to psychological problems; (2) spirituality can be a source of problems in and of itself; (3) people want spiritually sensitive help; and (4) spirituality cannot be separated from psychotherapy. We then discuss the defining characteristics of spiritually-integrated psychotherapy. It is based on a theory of spirituality, empirically-oriented, ecumenical, and capable of integration into virtually any form of psychotherapy. The paper concludes by considering potential problems associated with spiritually-integrated psychotherapy, including the risks of trivializing spirituality as simply a tool for mental health, reducing spirituality to presumably more basic motivations and drives, imposing spiritual values on clients, and overstating the importance of spirituality. Perhaps the greatest danger, however, is to neglect the spiritual dimension in psychotherapy. This paper sets the stage for the articles in this special issue of MHRC which describe the development and evaluation of several innovative approaches to spiritually-integrated psychotherapy.     

Ambiguity: Spiritual and psychotherapeutic aspects

Ambiguity is treated here as one of the interfaces between spirituality and psychotherapy. The multiplicity of spiritualities and the characteristics of spiritual leaders are discussed, the latter contrasted with the tenets of traditional psychotherapy. Similar and integrative aspects of spiritual and psychotherapeutic sojourners are examined.     

Ethical considerations of integrating spiritual direction into psychotherapy

Integrating spirituality and religion into clinical practice or psychotherapy has become a significant area of interest in the mental health field today. This article focuses more specifically on integrating spiritual direction into psychotherapy, discusses ethical issues involved, and suggests ethical guidelines for the appropriate and helpful use of spiritual direction in the context of psychotherapy and counseling.     

Sprirtual aspects of psychotherapy

This article addresses the relevance of spirituality to psychology and psychotherapy. It argues that spiritual experience is phenomenologically legitimate and worthy of study, especially by students of mental health. It utilizes Fox's (1985) definition of spirituality as unitive experience to show that spiritual experience is often present, overtly or covertly, within the ritual of psychotherapy. The paper argues that the therapist's adoption of an empathic posture is essentially a spiritual position. This position consists of a sense of peace, eternity, forgiveness, faith, love, truth, and God. These aspects are part of an integrated spiritual gestalt which is, though generally unacknowledged, fundamental to the communal healing process of psychotherapy. The paper concludes by asserting that greater involvement with the unitive (as opposed to the disunitive) represents a positive paradigmatic shift for psychology and humanity.     

Effects of Childhood Sexual Abuse on Client Spiritual Well‐Being

Forty‐three individuals receiving psychotherapy for childhood sexual abuse and 34 clients who sought psychotherapy for other reasons were compared on several aspects of spiritual functioning. The 2 groups did not differ significantly in spiritual well‐being. However, both groups scored lower than samples of medical outpatients and hospice workers. Most reported initiating and discussing spiritual issues during therapy, were satisfied and comfortable with these discussions, and rated spirituality as important to problem resolution. They also listed several obstacles to spiritual development. Possible research and practice implications are discussed.     

In Search of a Paradigm for Psychological and Spiritual Growth: Implications for Psychotherapy and Spiritual Direction

This article presents categories, drawn from the work of Abraham Maslow and Paul Tillich, which can be used to explore the similarities and differences in psychological and spiritual growth. While both dimensions of growth are interrelated, they are neither synonymous as terms nor fused as processes. Models for psychological growth cannot be superimposed onto spiritual growth because of some significant differences in the way in which self-awareness, spirit, and self-transcendence are defined and used by psychology and theology. It follows that psychotherapy and spiritual direction make unique contributions to human growth and need not be perceived as synonymous or competitive. There is a point at which psyche and spirit, psychotherapy and spiritual direction, meet: the place of healing.     

Religiosität und Spiritualität in der Psychotherapie

For many years religious and spiritual issues have been avoided in psychotherapy. In the face of social changes a more culturally sensitive psychotherapy is needed to professionally deal with religious backgrounds, spiritual needs and spiritual resources. A remarkable spiritual turn has recently been observed particularly in psychoanalysis, which was originally very antireligious. Health research studies are exploring the healing craft of religious virtues and values. It is important to discern between an empirically proven healing method and an ideologically founded promise of salvation. It is the task of the therapist to find out whether the patient's religiosity or spirituality is part of the problem or part of the solution.     

A group approach to guilt in depressive and suicidal patients

Summary A psychiatrist and a pastoral psychologist considered the problem of guilt as a source of alienation in depressed and suicidal patients by using a four-dimensional approach in a group psychotherapy setting. This involved functioning as cotherapists representing theological and psychiatric orientations and utilizing both didactic and insight-oriented approaches to elicit and explore meaningful material related to guilt feelings. With a number of exceptions, the patients did not appear to make a sharp distinction between the cotherapists' roles. The didactic openings on guilt served to provoke ready discussion of personal conflicts involving guilt feelings, especially in the silent patients who were not easily drawn into spontaneous discussion.     

Quality of life

This article gives an overview of the field of psychotherapy in relation to other relevant fields such as body-therapy and spiritual counselling. It is shown how psychotherapy defines itself in isolation from or in comparison with its sister disciplines. Political boundaries between professions are described. The field of transformation is shown to be encompassing not only the health professions, the psychotherapy professions, and the professions dealing with spiritual emergency, but it can also be seen to contain intra-personal, interpersonal and extra-personal (social) dimensions.     

Holism in Psychotherapy and Spiritual Direction: A Course Correction

The authors offer a course correction for understanding the term holism as used in spiritually oriented psychotherapy literature. This is done to allow the relationship between psychotherapy and spirituality to expand beyond limited dualistic conceptualizations. They first address numerous sources from which spiritually oriented psychotherapy arose and then explore the ill‐defined relationship between the psychological and the spiritual dimensions of human existence. Next, holism is distinguished from 2 common forms of dualistic “elementism” that are frequently misrepresented as holism. The authors conclude by presenting a holistic conceptualization of the relationship between the dimensions of psychotherapy and spirituality.     

Cognitive-Behavioral Versus Supportive Psychotherapy for Intermittent Explosive Disorder: A Randomized Controlled Trial

Few clinical trials have evaluated the efficacy of psychotherapy for Intermittent Explosive Disorder (IED). The present study tested the efficacy of a cognitive behavioral intervention (versus supportive psychotherapy) among adults with IED. In this randomized clinical trial, 44 participants with IED (22 men and 22 women) aged 20–55 years completed twelve 50-minute individual sessions of either a multi-component cognitive behavioral intervention for IED (n = 19) or a time equated supportive psychotherapy (n = 25). At baseline, posttreatment, and 3-month follow-up, all participants received the Overt Aggression Scale–Modified, which was conducted by an interviewer who was blind to the participant’s study condition. During these visits, participants also completed self-report measures of relational aggression (Self-Report of Relational Aggression and Social Behavior), anger (State-Trait Anger Expression Inventory-2), cognitive biases (e.g., Social Information Processing Questionnaire Attribution and Emotional Response Questionnaire), and associated symptoms (e.g., Beck Depression Inventory). Primary study outcomes were aggressive behavior and anger. Though participants in both treatments tended to improve over time, the cognitive behavioral intervention was superior to supportive psychotherapy in decreasing aggressive behavior and relational aggression. These findings support the efficacy of a multicomponent cognitive behavioral intervention in treating aggression in IED.     

Integrating Spirituality and Religion Into Psychotherapy: Persistent Dilemmas,Ethical Issues,and a Proposed Decision-Making Process

Religion and spirituality are important aspects of the lives of most psychotherapy clients. Unfortunately, many psychotherapists lack the training to effectively and ethically address these issues with their clients. At times, religious or spiritual concerns may be relevant to the reasons clients seek treatment, either as areas of conflict or distress for clients or as sources of strength and support that the psychotherapist may access to enhance the benefit of psychotherapy. This article reviews persistent ethical issues and dilemmas relevant to providing psychotherapy to clients for whom issues of religion and spirituality are clinically relevant. Ethical considerations include assessment, advertising and public statements, informed consent, competence, boundary issues and multiple relationships, cooperation with other professionals, and how to effectively integrate religious and spiritual interventions into ongoing psychotherapy. A decision-making process is presented to guide psychotherapists in their clinical work with clients for whom religious and spiritual issues are salient or clearly linked to their presenting problems.     

Client Perspectives on Spirituality in the Therapeutic Relationship

There has been increasing interest in the integration of spirituality into psychotherapy in the last 10 years, yet we have very little in-depth information about clients' perspectives on spirituality in the counseling relationship to help guide this integration. Using a narrative methodology to explore the counseling experiences of 12 spiritually-committed clients in detail, this study suggests that clients who may not identify as traditionally religious may still view the entire process of psychotherapy through a spiritual lens. Furthermore, their spirituality may guide their interpretation of therapy, their expectations of the therapist, and their choice to engage in or terminate treatment in complex ways. By exploring the experiences of this growing breed of spiritually-committed clients, the results shed new light on the dimensions that deserve consideration as we think about how to respond to a client's spiritual needs in psychotherapy.