Therapist Role in Narrative Group Psychotherapy

With its assumptions about the interpersonal origins of individual learning, narrative theory suggests certain leadership functions for group therapists: providing a perspective on how multiple meanings may be constructed about experience; leading the process of deconstructing individual narratives through careful questioning to distinguish persons from problems; enlisting participants in active awareness and engagement with group dynamics and group process; and enabling the co-creation of a group narrative through the development of a new community of conversations.     

Therapist Spiritual and Religious Values in Psychotherapy

In training and in supervision, counselors learn to be cognizant of personal values (e.g., spirituality, religiosity), yet they are enjoined to except them from practice. This article examines the nature of therapist spiritual and religious values and the impact of these values on the practice of psychotherapy. A goal of effective treatment should be the integration of therapist spiritual and religious values with therapist epistemic values in order to accommodate the spiritual and religious needs of both client and counselor. Counselor spiritual and religious values can contribute to therapy, even when the therapist is engaged in a dialectic involving personal and epistemic values.     

Parent Involvement Project

This article describes a project designed to provide assistance to parents of exceptional children in western Pennsylvania. The format for eight parent sessions is presented.     

Therapist, Parent, and Youth Perspectives of Treatment Barriers to Family-Focused Community Outpatient Mental Health Services

This exploratory qualitative study describes treatment barriers to receiving family-focused child mental health services for youths with disruptive behavior problems from multiple perspectives. Data were collected during a series of focus groups and interviews, including: 4 therapist focus groups (n = 26), 3 parent focus groups (n = 14), and 10 youth (10–13 years) semi-structured interviews. Data analysis followed inductive, iterative processes typical of qualitative research using an editing style and thematic content analysis approach. Therapist, parent, and youth stakeholder participants discussed perceived barriers to effective treatment, the problems with current child outpatient therapy, and desired changes (i.e., policy, intervention, etc.) to improve mental health services. Results indicate similar themes around treatment barriers and dissatisfaction with services within and across multiple stakeholder groups, including inadequate service system support, lack of family involvement and feeling overwhelmed with the complexities of families’ needs; however, parents and therapists, in particular, identified different contributing factors to these barriers. Therapists highly endorse using family-focused therapy and desire parent participation; however, parents feel unsupported by their child’s therapist. Parents’ report feeling blamed and not heard by service providers which negatively impacts their attitude about service delivery, causing discomfort and resistance to participation in their youth’s treatment. Youth also discussed dissatisfaction with mental health services, specifically related to their direct experiences in therapy, and desired more active, directive family-focused approaches. Overall, stakeholders reported much frustration and dissatisfaction with current community-based outpatient child therapy services. Study findings can inform service provision, intervention development, and future research.     

Therapist Interventions and Skills as Predictors of Dropout in Outpatient Psychotherapy

The current study employed machine learning to investigate whether the inclusion of observer-rated therapist interventions and skills in early sessions of psychotherapy improved dropout prediction beyond intake assessments. Patients were treated by postgraduate clinicians at a university outpatient clinic. Psychometric instruments were assessed at intake and therapeutic interventions and skills in the third session were routinely rated by independent observers. After variable preselection, an elastic net algorithm was used to build two dropout prediction models, one including and one excluding observer-rated session variables. The best model included observer-rated variables and was significantly superior to the model including intake variables only. Alongside intake variables, two observer-rated variables significantly predicted dropout: therapist use of feedback and summaries and treatment difficulty. Although not retained in the final prediction model, the observer-rated use of cognitive techniques was also significantly correlated with dropout. Observer ratings of therapist interventions and skills in early sessions of psychotherapy improve predictors of dropout from psychotherapy beyond intake variables alone. Future research could work toward personalizing dropout predictions to the specific dyad, thereby improving their validity and aiding therapists to recognize and react to increased dropout risk.     

Parent Perspectives on Family Involvement in Therapeutic Foster Care

There has been an increasing focus on family involvement in the treatment of children with serious emotional disorders, but it has received only limited attention in relation to out-of-home placements. I present the findings from a qualitative study of family involvement from the perspectives of parents whose children were placed in therapeutic foster care (TFC). Parents' perspectives on their involvement in placement decisions, relationships with professionals and TFC providers, practices related to family involvement, barriers to involvement, and strategies to enhance family involvement are described. Parents of children in TFC wanted to have contact with their children and to participate in decision making. They described relationships and practices that contributed to their involvement.     

Effects of Equine-Facilitated Psychotherapy on Post-Traumatic Stress Symptoms in Youth

Equine-assisted therapy has become an increasingly popular complementary mental health treatment approach, but there is limited empirical research assessing the effectiveness of this practice. In particular, equine-facilitated psychotherapy has many potential benefits for the treatment of trauma in youth. The purpose of the proposed study was to investigate changes in levels of post-traumatic stress symptomatology and levels of the human-animal bond in children and adolescents ages 10–18 over the course of a 10-week equine-facilitated psychotherapy (EFP) intervention. Youth in the treatment group (n?=?36) participated in 10 weekly two hour EFP sessions, and were compared on changes in post-traumatic stress symptoms with a control group of participants (n?=?32) who continued to receive the already existing traditional therapeutic services provided by their treatment facility or outpatient therapist. Findings suggested a significant decrease in post-traumatic stress symptoms across the intervention for both the treatment and control group, but the treatment group did not decrease significantly more than the control group. These findings suggest that EFP may be an effective additional treatment modality for post-traumatic stress symptoms, but there was no evidence from this initial study that EFP was significantly more effective than traditional office-based therapy. Further research and discussion of the relative benefits of EFP compared to traditional treatment modalities is warranted.     

The Role of Parent-Child Interaction in Community-Based Youth Relationship Education

This study sought to answer whether there is an association between parent-adolescent relationship processes and adolescents' awareness of unhealthy relationships. Adolescent awareness of unhealthy relationships was measured using a retrospective pre/post survey after participation in a relationship education (RE) program that has been adapted for use with youth. Supportiveness in the parent-child relationship was measured at pre-test. The sample consisted of 6984 adolescents aged 11–18. The sample was fairly representative of the areas from which it was drawn: 54% European American, 36% African American. Results revealed significant improvement in awareness of unhealthy relationships after program participation. Greater supportiveness predicted greater change in the outcome. This suggests that RE programs targeted at youth should specifically inform parents of goals so that they may be reinforced in parents' interactions with their adolescents.     

Therapist Self Disclosure in Group Psychotherapy from an Intersubjective and Self Psychological Standpoint

The history of therapist self disclosure is traced from the early struggles of Ferenczi and Burrow to its valued, yet still ambivalent, contemporary status. The symmetry of self disclosure by therapist and group members is differentiated from the parity of their different roles and responsibilities. Using a case example, the process is discussed through which a therapist's self disclosure fosters task-appropriate satisfaction of selfobject needs as it also helps group members articulate and loosen archaic selfobject binds. The therapy group is described as a transitional space within which a therapist's disclosure offers members an intersubjective bridge to the therapist as well as a model for members' own active participation in the group's work.     

Therapist Grief and Functional Analytic Psychotherapy: Strategic Self-Disclosure of Personal Loss

Functional Analytic Psychotherapy (FAP), a behavioral approach that focuses on the development of genuine and meaningful therapeutic relationships including the strategic use of disclosure, provides a framework for therapist self-disclosure during times of personal loss. This article briefly outlines FAP and provides an example of FAP in practice following the death of the first author’s mother. Qualitative data from a client questionnaire on the impact of this disclosure are presented, which suggest that the disclosure was a positive experience for most but not all clients. The article concludes with clinical guidelines that can enhance therapeutic effectiveness whether or not therapists choose to disclose loss to their clients and general precautions for treading in this emotionally intense territory.     

Promoting Parent Involvement in Schools to Serve At-Risk Students

The recent educational literature and popular media reflect growing concern about deficient student achievement in the regular education system, a problem that has resulted in inappropriate classification of students as handicapped, as well as resulted in increased dropout rates. A wide range of variables contribute to school failure, including a complex interaction of home and school characteristics. For this reason, efforts to intervene with students who are at-risk for school failuer must include attention to the relationship between parents and school professionals. This paper reviews the literature on parent involvement, which shows that increased participation by parents in educational programs has a positive relationship to student achievement. Specific roles for parents are examined, followed by guidelines for promoting parent involvement.     

Authority,Psychotherapy and the Authority of the Therapist in the Religious Haredi Community

This article considers the meaning and significance of authority, and its relevance to the transference process, within the framework of psychotherapy in the orthodox Jewish (Haredi) community in Israel. In this community, deeply-rooted habits of obedience to the commandments of the Torah and the authority of the Rabbi are integral to maintaining an orthodox way of life. Clinical vignettes with Haredi patients are presented to illustrate the complexities that arise when both patient and therapist belong to the orthodox community, and highlight the authority-related issues that are central to the therapy. This combination of factors requires a sensitive and finely-tuned approach which will enable the therapist to maintain the treatment framework while still accommodating the orthodox way of life.     

Father Involvement in Parent Training for Oppositional Child Behavior

Outcome literature (1981 to 1988) on behavioral parent training interventions for nonhandicapped children with oppositional behavior is reviewed to assess the extent and effects of father involvement in parent training. Thirteen studies were found that included some father involvement. Weaknesses of these studies include a failure to observe and measure changed in father-child interactions, a lack of emphasis on the impact of the marital relationship, a lack of attention to similarities in parental child management strategies, and a lack of assessment of paternal characteristics. Further research to assess the effects of including fathers on parent training outcomes can improve the efficiency and effectiveness of these interventions.     

Longitudinal Outcomes of Child Parent Psychotherapy: Response to Commentaries

Research on Child and Adolescent Psychopathology - In response to the commentaries provided by Chu et al. (2020), Harmon et al. (2020), and McMahon & Maxwell (2020) on our longitudinal...     

Adolescent Group Psychotherapy: Collaborative Opportunity for Patients,Parents, and Therapist

This brief report examines the uses of an Observation Team with a Parent Support Group. In particular, attention is placed on the idea of the Observation Team acting as a Reflecting Team in the final session of the group's life. Using the Observation Team in this manner has evolved from an amalgamation of ideas from family therapy and group therapy theory.