The psychotherapeutic utility of the five-factor model of personality: a clinician's experience.

This article summarizes experience using the five-factor model of personality, operationalized by the NEO Personality Inventory (NEO-PI), to facilitate psychotherapy treatment with 119 private-practice, outpatient, psychotherapy patients and their family members over a period of 2 years. Trait theories such as the five-factor model implicitly challenge the premises of much clinical theory, yet they can be useful to clinicians, as they provide a detailed, accurate portrait of the client's needs, feelings, proximate motives, and interpersonal style. I suggest that: Neuroticism (N) influences the intensity and duration of the patient's distress, Extraversion (E) influences the patient's enthusiasm for treatment, Openness (O) influences the patient's reactions to the therapist's interventions, Agreeableness (A) influences the patient's reaction to the person of the therapist, and Conscientiousness (C) influences the patient's willingness to do the work of psychotherapy. Fundamental questions raised by the five-factor model about the nature of psychopathology and psychotherapy are discussed.     

Learning from experience: The value of analysing Avalon

In this article some of the experiences and insights gained from roughly fifteen years of conducting a long term study of Glastonbury are examined. Glastonbury, a small town in the south west of England, has become a multivalent pilgrimage site for a variety of spiritual seekers, and an icon of integrative spirituality (my preferred term for ‘alternative’ or ‘New Age’ spirituality).The concept of vernacular religion is explained, and its appropriateness in relation to both place-centred study and research into integrative spirituality is demonstrated. The rationale and some of the methodological complexities underlying this type of study are explored, and some of the trends and phenomena that the long term observation of one location has revealed are considered. The contextual detail and depth of knowledge gained from such long term study feed into an appreciation of both the internal dynamics of Christianity in Glastonbury, for example, and the growing institutionalisation of the Glastonbury Goddess movement and the spread of its influence through a variety of conduits. The role of the internet in framing expectations and presentations of Glastonbury is examined, and research relating to its unique spiritual service industry is briefly summarised.While Glastonbury is by no means ‘typical’, it is indicative of a number of trends in relation to ‘integrative’ spirituality and therefore lessons learned from there can have wider implications for the study of phenomena increasingly common in the contemporary milieu.     

The therapeutic community in the local community: Social networks between therapeutic community and supported housing

In this paper, the authors present a model for therapeutic community programmes for those with severe and enduring mental ill health, based on social networks. These programmes have given birth to a range of therapeutic community which are, in fact, an innovative form of group psychotherapy. These new model do not depend on communal living. Some are groupings of apartments, others day units. Work schemes also feature here. And yet, as the authors outline, various components need to be present if these are to be considered genuine therapeutic communities and not just supported housing schemes. Additionally, a certain kind of training and clinical supervision is needed for the staff.     

The therapeutic relationship as a paradoxical experience

The therapeutic relationship exists within multiple levels of reality—including that of ordinary life and that of the therapeutic frame. This interplay between these two levels of reality gives rise to paradoxical experiences for both participants. Certain “principles”; or “rules”; of technique can be understood as a means of enabling the therapist to cope with what is usually referred to as “boundary”; issues. It is essential that the analyst or therapist demonstrate capacity to shift playfully from one level of reality to another. The “rule”; of abstinence and the asymmetry of desire that exists between the two participants are discussed. Gratification within the therapeutic frame is paradoxical in that gratification at one level of reality leads to privation at another level of reality. These paradoxical experiences for both patient and analyst are examined in relation to projective identification and to the analyst's countertransference.     

Classroom Climate and Political Learning: Findings from a Swedish Panel Study and Comparative Data

Numerous studies have shown that an open classroom climate for discussion increases students' civic knowledge. However, most previous studies draw on cross‐sectional data and have not been able to show that the effect is causal. This article presents results from a Swedish panel survey following students during the first year in the gymnasium (upper secondary level). Using this study, we are better equipped to evaluate the link between an open classroom climate and political knowledge. Results suggest that the effect is causal. A 10% increase in open classroom climate is associated with about 5 percentage points higher knowledge. The beneficial effect of an open classroom climate is an important insight that should be seriously considered not only by researchers but also by educational policy makers, school managements, and teachers.     

Medical education in a community model of care: The future of medical education in a large academic community hospital

Profound changes in the practice of medicine have led to new demands on the profession and on the process of medical education. In recognition of the expanded role of a physician as a professional responsible for the welfare of individuals, Lehigh Valley Hospital has developed an ambitious, innovative Strategic Plan for Education. The plan entitled, Medical Education in a Community Model of Care, emphasizes the organizational importance of education in the hospital's achievement of its mission of community service. The Strategic Plan for Education is community focused. In addition to its primary role of serving its local community, the plan is intended as a educational model for organizations in other parts of the country.Preparation of this paper was supported by a grant from the Dorothy Rider Pool Health Care Trust.     

Adolescent sexuality in a therapeutic community: staff countertransference issues

Issues connected with sexuality such as heterosexual relationships, homosexuality, sexual identity, and seductiveness, create conflict and countertransference dilemmas for staff who work with psychiatric patients in a therapeutic community. When the therapeutic community is composed of adolescents, these issues are exacerbated since sexual identity and sexual development are major concerns. The staff reacts strongly to the issue of self-determination and violation/infringement on a basic human need. These philosophical differences have their roots in countertransference feelings. Staff sometimes find it difficult to confront adolescents on emotionally charged issues that have a sexual coloring. A system is proposed for articulating and working through these feelings. A unique solution is posited for solving this conflictual attitude (based on object relations theory), whereby the residential treatment center serves as the analog of the home in order to allow adolescents to develop a sense of self before they can move on to the halfway house where heterosexual behavior is allowed (as part of the therapeutic process). This facilitates the meeting of the "self" with the "other." This procedure is explored in light of Sullivan's concept of intimacy.     

Anxiety and coping with community disasters: The Israeli experience

This study compared anxiety levels and coping strategies in Israeli adults during the Al-Aqsa Intifada (n = 707) and under ballistic missile attacks targeted at Israeli civilians during the Persian Gulf War (n = 328). In view of the differences among the two disaster situations in terms of severity of impact, scope, duration, predictability, and controllability, it was hypothesized that higher levels of state anxiety would be observed for the terror attack than for the missile attack crisis. Furthermore, problem-focused coping was predicted to be more salient than emotion-focused coping during the Gulf War—at a time where more protective action could be taken. Overall, the data supported the hypotheses. The data are discussed and explicated in the context of stress and coping theory and research.     

The Wisdom Group: a psychotherapeutic model for elderly persons.

This article describes the "Wisdom Group," a therapy devised for the psychotherapeutic treatment of elderly persons. Preliminary work was done with five men of advanced age who were psychiatric in-patients with diagnoses of organicity and depression. The approach was effective in eliciting interaction during the meetings with each other and the group leader. The potential use of this intervention with a greater variety of elderly persons is discussed.     

Parents as therapeutic agents: The usefulness of filial therapy in a community mental health center

Filial Therapy, a program training parents as play therapists for their own children, has been found an effective part of the functioning of a child unit in a community mental health center. The basic philosophy and principles of Filial Therapy are identified. The use of parents as therapists is viewed as consistent with the growth of the community mental health movement and the concept of treating the context in which the child resides. The structure and flexibility of this model are delineated to provide the reader with a basis to introduce Filial Therapy in his/her own setting.     

The implementation of contextual therapy in the therapeutic community for substance abusers: a case study

Family therapy takes a special position in the therapeutic community for substance abusers (TC). In the early therapeutic communities, the family of origin was not considered as important for the substance abuser's recovery process, and was even labelled as part of the problem. It was only in the 1970s that the TC acknowledged the significance of family involvement in treatment. Nowadays, the contextual vision of Ivan-Boszormenyi-Nagy seems to have a strong impact on family counselling activities in Belgian TCs.
In this article, the integration of contextual thinking in the TC is discussed. By means of a case study, it is shown that there are some clear parallels between the treatment evolutions in family counselling and the peer group community. The central position of trust both in contextual therapy and the TC treatment model is an important common ground for stimulating integration. Some obstacles that can disrupt this integration process are discussed.