A Jewish Spiritual Perspective on Psychopathology and Psychotherapy: A Clinician's View

This paper will present a Jewish Spiritual Perspective on clinical work by examining key underlying values and attitudes in Judaism that relate to human behavior, mental health and illness. Common symptom presentations and family issues that have roots in culture will be explored. Contemporary and ancient spiritual coping tools will be suggested for use in clinical work and personal growth.     

Indian Perspective on Psychotherapy: Cultural Issues

India is in a state of transition between massively transformed ‘modern’ lifestyles on one hand and the influence of traditional values and customs on the other. In view of the current realities of urbanization, migration, globalisation and societal transformation, the mental health treatment needs have become complex. The article highlights the existing mental health issues and traces the development of various psychotherapeutic techniques in India. An effort has been made to look into the basic tenets of the Indian culture which have a bearing on the conceptualisation and practical application of psychotherapy in the Indian setting. The cross-cultural relevance and adaptability of western psychotherapies in multi-ethnic and collectivistic Asian culture are discussed. In view of the differences between the eastern and western approaches to mental health, challenges in culturally-responsive adaptations are highlighted. It is seen that psychological interventions among masses are beneficial if indigenous approaches based on paradigms like themes from Gita, are cross-fertilized with western psychotherapy. However, there is a need to generate empirical evidence for indigenization of psychological treatments.     

Career Development of Black South African Adolescents: A Developmental-Contextual Perspective

South Africa is undergoing rapid change in a post-apartheid era. This article uses the developmental-contextual perspective to examine the extent to which contextual and individual factors dynamically interact in the career development of Black South African adolescents. Furthermore, interventions that may assist in the career development of Black adolescents, as well as the implications of this research for counselors, are provided.     

Black Male Adolescents Navigating Microaggressions in a Traditionally White Middle School: A Qualitative Study

On the basis of qualitative case study analysis, this study offers in‐depth understanding of Black male middle school students' perceptions of racial microaggressions. It was found that Black male adolescents, depending on their backgrounds, are aware of different types of microaggressions. Implications for school counselors, teachers, and administrators are discussed. Basándose en análisis cualitativos de estudios de caso, este estudio ofrece un entendimiento en profundidad de las percepciones por parte de estudiantes varones Negros en la escuela media de microagresiones raciales. Se halló que los varones Negros adolescentes, dependiendo de su origen, son conscientes de distintos tipos de microagresiones. Se discuten implicaciones para consejeros escolares, profesores y administradores.     

Differences in Adjustment Issues for Male and Female Adolescents

In this article, the matter of gender differences that influence adolescent development is considered by means of an empirical investigation. Implications of the results are discussed for parents, teachers, and special services professionals.     

Transference-Focused Psychotherapy for Borderline Adolescents: A Neurobiologically Informed Psychodynamic Psychotherapy

In this article we first contextualize and then outline a model of TFP adapted for working with adolescents with Borderline Personality Disorders. We discuss how to take the normal developmental challenges of adolescence, such as separation-individuation in consideration, and how to support this in the context of the therapeutic work, while at the same time stimulating curiosity through clarification and confronting the adolescent with self-defeating and destructive patterns and dangerous behavior. Furthermore, we give examples of working with split–off parts of self and other representations through clarification to increase self-awareness and confrontations with contradictions within the adolescents communication and nonverbal behavior, with the aim of facilitating the integration of identity.     

Psychosocial Development and Black Male Masculinity: Implications for Counseling Economically Disadvantaged African American Male Adolescents

Few articles exist on issues related to counseling African American male adolescents. This article examines developmental and sex role factors and their importance for counseling interventions and the counselor-client relationship. Implications are drawn for counselors desiring to improve their abilities to assist this population.     

A Short-term Psychodynamic Supportive Psychotherapy for Adolescents with Depressive Disorders: A New Approach

Depression is one of the most common psychiatric disorders in both adolescents and adults. In this article, we introduce Short-term Psychodynamic Supportive Psychotherapy (SPSP) for adolescents, a relatively new form of psychodynamic therapy for depression that has been studied in a range of randomized controlled trials with adult patients. SPSP emphasizes the relational aetiology and significance of depression and is characterized by a supportive attitude which focuses more on working in the here-and-now relational patterns rather than interpreting transference manifestations. The supportive attitude of the therapist is advocated to engage the adolescent in the therapeutic relationship and to foster his or her innate developmental capacities by attending to previously unaddressed developmental needs. The developmental perspective’s interest in defense styles and stagnation resulting from problems in past and current relationships opens up opportunities for acquiring insight and change. The focus on relational functioning makes it a promising approach for adolescents because they can implement any positive change immediately in their actual environment, immersed as they are in many new and varied relationships.     

Therapy Expectations of Adolescents with Depression Entering Psychodynamic Psychotherapy: A Qualitative Study

Patient expectations about therapy have been regarded as a common factor affecting the course and outcome of psychotherapy. However, little is known about the expectations of adolescents. We aimed to explore the therapy expectations of young people (YP) with depression prior to psychotherapy. We conducted semi-structured interviews with six YP (5 female, 15–19 years old) entering psychodynamic outpatient treatment. Interviews were transcribed verbatim and analyzed using Interpretative Phenomenological Analysis. The careful analysis of the YPs’ accounts yielded the following four key themes: not knowing but being cautiously hopeful; therapy as a long and difficult process; therapy as a place to understand oneself and to develop; and the importance of the professional and interpersonal skills of the therapist. The findings suggest to foster realistic treatment and outcome expectations while at the same time individual therapists should pay careful attention to the specific expectations that YP bring into therapy.     

Resensitizing Men: A Male Perspective

Most of us accept that men are conditioned to behave as though they are always dominant, achieving, tough, and unsentimental and that, as a consequence, they erect elaborate defenses against feelings or thoughts that threaten to negate this self-concept. As therapists we often experience how difficult it is to move men off the cognitive level and info more effective places where they can experience their self-division and alienation. This article encourages counselors to appreciate the threats involved for men in becoming more intimate with themselves. In addition, it suggests some ways to facilitate this process, and pinpoints specific concerns and thoughts that male clients may have as they become more deeply involved in therapy.     

Special Issues in Psychotherapy with Minority Deaf Women

Abstract

Minority Deaf women have been traditionally underserved by mental health professionals, and specifically, therapists are unaware of issues unique to this population. It would be highly unlikely for a minority Deaf woman to have a therapist who matches her in racial background, hearing status, and communication mode. Therefore, the therapy process will be completely cross-cultural. Therapists who provide psychotherapy services to minority Deaf women need to be aware that their clients are members of a community where deafness is a culture and not a disability. Minority Deaf women are also likely to report feeling forced to choose between competing identities in order to get important needs met. In the following article, case examples are provided which illustrate some of the major issues that are likely to arise in therapy with minority Deaf women. These issues include: access to important information; communication, support and level of involvement with biological families; competing cultural demands; health concerns; and coping with chronic mental illness.     

Technical Considerations in the Psychotherapy of Traumatized Individuals: A Psychoanalytic Perspective

This paper addresses two specific aspects of clinical technique in the treatment of traumatized individuals. The first aspect involves the creation of a safe holding environment as an essential step for the emergence of trauma-related memories and the containment of the affects accompanying them. Such scenarios may appear in the clinical material only through the workings of "procedural memory." It is therefore important to contain and gradually decipher repetitive patterns of behavior and feelings of shame, guilt and rage that go with them. The second aspect examines the challenges such work poses to the analyst's containing capacities, credulousness and even his or her reality testing within a clinical situation. The resulting instability of the analyst's work ego can make it hard for him or her to remain vigilant yet empathic, and emotionally attuned but analytically skeptical. The analyst's flexibility to be utilized as a transference object, developmental object and self-object remains a critical determinant of the treatment outcome under such circumstances. The paper provides clinical material to illustrate these two aspects of clinical technique.     

Strategic Issues in the Psychotherapy of Patients with Narcissistic Pathology

Narcissistic personality disorder is a relatively uncommon diagnosis in clinical settings; however, these patients are frequently in need of and referred for long-term psychotherapy. Such patients may not seek therapy willingly but do so at a time when they experience sufficient vulnerability to accept therapy. Given these and other characteristics, the narcissistic patient can be challenging for therapists. This paper suggests some strategic approaches that may be employed with patients with narcissistic pathology. Partly, these approaches incorporate more contemporary understandings of narcissistic pathology such as appreciating that these patients can present both the grandiose and vulnerable elements of narcissistic pathology and that a gender focus using theories of masculinity may enlighten our approach to these patients. Specifically the strategies reviewed are: starting therapy by assessing for the patient’s vulnerable characteristics and offering some gratification for their need for acknowledgement; monitoring and managing the risk of suicide and comorbid disorder in patients with narcissistic pathology and in the working through phase of therapy, recognizing the need for patients to developed increased self-cohesion and the importance of supervision/consultation in the working through process of therapy.