Nonerotic dual relationships between therapists and clients: the effects of sex, theoretical orientation, and interpersonal boundaries

We surveyed 223 APA members to investigate the roles of therapists' sex, theoretical orientation, interpersonal boundaries, and clients' sex in predicting therapists' assessments of the ethicality of nonerotic dual relationships with their clients. Results indicated that therapists' sex, interpersonal boundaries, and theoretical orientation influenced ethical judgments of these relationships. Theoretical and practical implications of our findings are discussed.     

Contrasting four major family therapy paradigms: implications for family therapy training

Four major paradigms of family therapy are contrasted: affective-experiential, structural, strategic and Milan. The differences are defined according to the way in which therapists think and behave in relation to their premises about change, and they are discussed under the following headings: historical roots and understanding of symptom formation; therapists' stance and techniques used in change; focus, goals and locus of change; and time perspective in change. Some suggestions are made with regard to training family therapists based on the differences that emerge when contrasting these models of family therapy.     

Experiential Tasks and Therapist Bias Awareness

All therapists have values, assumptions, and beliefs about groups of people who are different from the dominant culture. How the therapeutic process is shadowed by therapists' assumptions and attitudes toward ethnic minorities is discussed. The author provides experiential techniques such as visualization, role playing, role reversal, family sculpturing, and a written assignment as a vehicle to heighten a family therapists' awareness of underlying assumptions and biases toward clients of an ethnic minority.     

Systems factorial technology with R

Systems factorial technology (SFT) comprises a set of powerful nonparametric models and measures, together with a theory-driven experiment methodology termed the double factorial paradigm (DFP), for assessing the cognitive information-processing mechanisms supporting the processing of multiple sources of information in a given task (Townsend and Nozawa, Journal of Mathematical Psychology 39:321–360, 1995). We provide an overview of the model-based measures of SFT, together with a tutorial on designing a DFP experiment to take advantage of all SFT measures in a single experiment. Illustrative examples are given to highlight the breadth of applicability of these techniques across psychology. We further introduce and demonstrate a new package for performing SFT analyses using R for statistical computing.     

Therapists' emotional reactions to patients as a mediator in cognitive behavioural treatment of panic disorder with agoraphobia

The aims of this study were to examine whether therapists' emotional reactions to their patients mediate the effect of personality disorders and interpersonal problem behaviours on the outcome of treatment, focusing on an Axis I disorder; and whether therapists' reactions mediate the effect of personality disorders on the course of interpersonal problems. Therapists completed a checklist of emotional reactions to individual patients after the end of residential cognitive or guided mastery therapy for 46 inpatients with panic disorder with agoraphobia. The severity of DSM-III-R personality disorder was related to therapists' insecurity feelings, but not to interest and anger. A higher level of therapists' insecurity feelings was related to less reduction in self-reported agoraphobic avoidance during treatment, whereas therapists' emotions were unrelated to symptomatic course after treatment. Therapists' insecurity feelings appeared partly to mediate the relationship between patients' severity of personality disorder and persistence of patients' interpersonal dominance and nurturance problems.     

My Family Made Me Do It: The Influence of Family Therapists'' Families of Origin on Their Occupational Choice

This study is an empirical test and exploration of the folklore about family life correlates of family therapists' occupational choice. The folklore is translated into systems concepts, including role complementarity and the mutually determining effect of process and roles. Fifty-nine family therapists, 49 siblings of the therapists, and 51 undifferentiated, non-helping professionals were compared on FACES (29), The Complementary Role Questionnaire, and on demographic data. Inconsistencies in the results led to a critique of the clinical faithfulness of current systems measures. Family therapists did not differ on FACES, but did differ in aspects of roles from their siblings and from the control professionals.     

Experiences of Christian clients in secular psychotherapy: a mixed-methods investigation

Eleven Christian former clients were sampled to uncover factors contributing to positive versus negative experiences in secular psychotherapy. The qualitative results indicated that although many participants felt hesitant to discuss their faith due to uncertainty about their therapists' reactions, positive experiences were reportedly facilitated by therapists' openness to understanding clients' faith and giving clients control over how much, when, and how to discuss their religious beliefs and practices. Dissatisfied clients reported that their therapists expressed opposing religious views or avoided discussing religious or spiritual issues. Participants' self-reports of the working alliance and of their therapists' expertness, attractiveness, and trustworthiness were largely consistent with the narrative data, but the alliance scores were somewhat more sensitive to participants' positive versus negative evaluations of their therapy experience. That is, several participants rated their therapists' personal characteristics quite favorably but indicated poor agreement with their therapists on the goals or tasks of treatment.     

Client and therapist variability in clients' perceptions of their therapists' multicultural competencies

This study examined therapist differences in their clients' ratings of their therapists' multicultural competencies (MCCs) as well as tested whether therapists' who were rated as exhibiting more MCCs also had clients who had better therapy outcomes (N = 143 clients and 31 therapists). All clients completed at least 3 sessions. Results demonstrated that therapists accounted for less than 1% of the variance in their clients' Cross-Cultural Counseling Inventory–Revised (CCCI-R; T. D. LaFromboise, H. L. K. Coleman, & A. Hernandez, 1991) scores, suggesting that therapists did not differ in terms of how clients rated their MCCs. Therapists accounted for approximately 8.5% of the variance in therapy outcomes. For each therapist, their clients' CCCI-R scores were aggregated to provide an estimate of therapists' MCCs. Therapists' MCCs, based on aggregate CCCI-R scores, did not account for the variability in therapy outcomes that were attributed to them. Additionally, clients' race/ethnicity, therapists' race/ethnicity, or the interaction of clients'–therapists' race/ethnicity were not significantly associated with clients' perceptions of their therapists' MCCs.     

Relationships among client and counselor agreement about the working alliance, session evaluations, and change in client symptoms using response surface analysis

Two studies explored how counselor and client agreement on the therapy alliance, at the beginning of treatment, influenced early session evaluations and symptom change. Unlike prior studies that operationalized alliance convergence as either a profile similarity correlation or a difference score, the present study used polynomial regression and response surface analysis to examine agreement. Study 1 explored the impact of working alliance congruence on session depth and smoothness at the 3rd session of treatment with 36 client-counselor dyads. Results revealed that session smoothness was greater when clients' and therapists' perceptions of the working alliance were in agreement and high compared with when they were in agreement and low. In addition, clients rated sessions less smooth when their ratings of the alliance were lower than their therapists' ratings of the alliance, and they rated sessions as more smooth when their ratings of the alliance were higher than their therapists' ratings of the alliance. The authors did not find a significant relationship with session depth. In Study 2, the authors explored the impact of working alliance congruence, at the 3rd session of therapy, on symptom change for 63 client-counselor dyads. Results revealed that as the therapist and client have more positive agreement on the perceived alliance at the beginning of the treatment, there is greater symptom change. The authors also found that the consequences of alliance disagreement are the same regardless of who rated the alliance higher than the other. Implications and recommendations for future research are discussed.     

Assessment of therapists' and patients' personality: relationship to therapeutic technique and outcome in brief dynamic psychotherapy

My first focus of this study was to explore therapists' personal characteristics as predictors of the proportion of interpretation in brief dynamic psychotherapy (N=39; maximum 40 sessions). In this study, I used data from the Norwegian Multicenter Study on Process and Outcome of Psychotherapy (1995). The main finding was that therapists who had experienced good parental care gave less interpretation (28% variance was accounted for). Therapists who had more negative introjects used a higher proportion of interpretation (16% variance was accounted for). Patients' pretreatment characteristics were not predictive of therapists' use of interpretation. The second focus was to investigate the impact of therapists' personality and the proportion of interpretation on the development of patients' maladaptive defensive functioning over the course of therapy. Better parental care and less negative introjects in therapists were associated with a positive influence and accounted for 5% variance in the reduction of patients' maladaptive defense.     

Searching for the facts in the clinical setting with couples

This paper describes a research proposal to examine whether or not the underlying analytic concepts behind the couple psychoanalytic psychotherapy model used at the Tavistock Marital Studies Institute in London are sufficiently coherent, both conceptually and clinically, to be used as the basis for a system of audit which respects the unique data produced in analytic psychotherapy. This 'psychoanalytic' system of audit is one which is characterized particularly by the use of the therapists' subjectivity, rather than attempts to be objective and gather data through such things as random controlled trials or generic outcome questionnaires. The paper describes the approach to the subject and the mix of qualitative and quantitative methods used. As the Tavistock Marital Studies Institute has a history of contact with Jungian analysts from the Society of Analytical Psychology, Jungian concepts are included in the model. The research is part of a professional doctorate in couple psychoanalytic psychotherapy at the Tavistock Marital Studies Institute in conjunction with the University of East London, entitled 'Conceptualizing audit in Couple Psychoanalytic Psychotherapy'.     

Systemic psychotherapy as an intervention for post‐traumatic stress responses: an introduction,theoretical rationale and overview of developments in an emerging field of interest

The purpose of this article is to critically examine the literature to provide a rationale for including systemic family therapy (SFT) in the psycho‐social treatment of people suffering the impact of post‐traumatic stress (PTS). Attention is drawn to the relatively underdeveloped academic literature on PTS and the family. The impact of PTS is conceptualized within a psycho‐social framework and the current evidence base for psycho‐social interventions for PTS responses is described, highlighting the opportunity and need to undergird this area of daily practice. The impact of PTS on the family at multiple levels is identified, emphasizing its recursive nature. The case for SFT is articulated and a range of models of family intervention for PTS briefly reviewed, concluding with an emphasis on Walsh's key processes in family resilience as a framework for practice.     

The impact of transference and countertransference in activity group therapy

The effective use of countertransference reactions in children's group psychotherapy is discussed. Countertransferences activated by the group dynamics or by the dynamics of individual group members must be analyzed and understood by the therapist if they are to be utilized. The analysis of resistances in children's therapy groups is enhanced by the therapists' awareness of their own countertransference reactions. Clinical examples are presented.     

The process of enabling change: a study of therapist interventions in family therapy

We describe the application of discursive analysis to the task of researching family therapy process. Through the analysis of a central theme in two family therapy treatments, we found that individual family members move to using a wider range of discourses on the central theme by the end of therapy. Using the example of one family's therapy sessions, we examine how the therapist contributes to the new meanings and views that emerge, and present our analysis of the therapists' interventions in relation to the 'production' of these alternative meanings. It is argued that discourse analysis can fruitfully be applied to family therapy process research and could contribute to theoretical concepts of change and therapeutic competence.     

Information-processing architectures in multidimensional classification: a validation test of the systems factorial technology

A growing methodology, known as the systems factorial technology (SFT), is being developed to diagnose the types of information-processing architectures (serial, parallel, or coactive) and stopping rules (exhaustive or self-terminating) that operate in tasks of multidimensional perception. Whereas most previous applications of SFT have been in domains of simple detection and visual-memory search, this research extends the applications to foundational issues in multidimensional classification. Experiments are conducted in which subjects are required to classify objects into a conjunctive-rule category structure. In one case the stimuli vary along highly separable dimensions, whereas in another case they vary along integral dimensions. For the separable-dimension stimuli, the SFT methodology revealed a serial or parallel architecture with an exhaustive stopping rule. By contrast, for the integral-dimension stimuli, the SFT methodology provided clear evidence of coactivation. The research provides a validation of the SFT in the domain of classification and adds to the list of converging operations for distinguishing between separable-dimension and integral-dimension interactions.     

The curious case of the refrigerator-TV: similarity and hybridization

This article examines the role of similarity in the hybridization of concepts, focusing on hybrid products as an applied test case. Hybrid concepts found in natural language, such as singer songwriter, typically combine similar concepts, whereas dissimilar concepts rarely form hybrids. The hybridization of dissimilar concepts in products such as jogging shoe mp3 player and refrigerator TV thus poses a challenge for understanding the process of conceptual combination. It is proposed that models of conceptual combination can throw light on the judged future success and desirability of hybrid products in general. The composite prototype model proposes two stages of conceptual combination. In the first stage, the concepts are aggregated into an additive hybrid, simply by forming the union of the two sets of attributes. In the second stage, any conflicting attributes are identified and resolved, often with the introduction of emergent attributes, resulting in an integrative hybrid. Across four studies that varied the similarity and type of hybrid products, similar and integrative hybrids were valued more than dissimilar and additive hybrids. Critically, though, dissimilar hybrids were also highly valued if they were integrative. Results supported the two stages proposed by the composite prototype model, and implications for other models of hybrid formation are discussed.     

What Happens When Therapists Feel Bored or Anxious? A Qualitative Study of Distracting Self-Awareness and Therapists' Management Strategies

Using a qualitative methodology, we investigated novice and experienced therapists' experiences of and strategies for managing distracting self-awareness. We found that novice therapists were most aware of anxiety and critical self-talk, whereas experienced therapists were most aware of boredom and outside distracters. In addition, although therapists tended to manage distracting self-awareness through self-coaching and refocusing on the client, novice therapists specifically mentioned managing problematic self-awareness through self-disclosure. In contrast, experienced therapists tended to manage problematic self-awareness by using thought stopping techniques. The results provide new avenues for examining therapists' in-session experiences and for investigating the effectiveness of different management strategies.     

Connections and Themes of Spirituality in Family Therapy

In this article, we provide an overview of current considerations of spirituality in family therapy literature and practice. We suggest that whatever practice of therapy is undertaken, implicity or explicitly it will reflect views on the connection between spirituality and family therapy--connections involving clients' and therapists' beliefs. A thematic framework based on dimensions of the instrumental and metaphysical is outlined. Clinical approaches and practices within these connections are discussed.     

Therapeutic neutrality reconsidered

This paper suggests that therapists' tendency to ignore the impact of their own religious beliefs on their patients constitutes an area of potential abuse of psychotherapy. The author reviews the religious stance of the founders of psychotherapy, as well as recent criticisms of the therapeutic process, and proposes steps to safeguard against the inadvertent fostering of therapists' religious views on the patient.     

Theory and method for research on aptitude processes

The theoretical and methodological concepts available to, and needed by, research on aptitudes as cognitive processes are discussed. Contemporary views of cognitive processes are examined in relation to individual difference constructs and methods used to examine their reliability and validity. Individual difference constructs are discussed in relation to cognitive process models and research thereon. Studies of short-term memory processes are reviewed to demonstrate the complementary strengths and weaknesses of experimental and correlational methods and concepts. A coordinated approach to the study of aptitude as information processing is suggested.