The Relationship Between Client Emotional Expressions, Therapist Interventions, and the Working Alliance: An Exploration of Eight Emotional Expression Events

The relationship between client emotional expression and therapist interventions was studied in two working alliance conditions. An events-focused methodology was used to examine a total of 8 events taken from a variety of therapeutic orientations. Results indicated that, in the presence of a good client–therapist relationship, therapists showed higher levels of empathy and effectively focused on the immediately expressed feelings; in turn, their clients were engaged in exploration of feelings. In poor-relationship dyads, clients expressed negative feelings toward the therapists. Interventions rated as effective by clinical judges were characterized by accurate therapist understanding of clients' emotional expressions and working with strains in the therapeutic relationship. Ineffective interventions were associated with inaccurate assessments of clients' emotional states. Intensive analysis of these sessions led to three distinct models of in-session emotional expression events. Theoretical and practical implications of these models will be discussed.     

The Relationship Between Therapist Characteristics and Decreased Medical Utilization: An Exploratory Study

This was an exploratory study examining the relationship between the therapist characteristics of age, experience, gender, and profession and the medical utilization of clients. Marriage and family therapists, clinical social workers, and psychologists participated in the study along with 197 clients as identified by archival research methods. The results of logistic regression analysis suggested that psychotherapy in general, rather than professional training or therapist characteristics is responsible for reductions in healthcare utilization.     

Therapy Outcomes: Client Perception and Similarity with Therapist View

This study examined clients' perceptions of therapy outcome and how those perceptions related to therapist views. Additionally, the effects of client and therapist gender and ethnicity, and the match on these variables (e.g., female therapist-female client) were examined. Results showed that clients generally improved from both the client and therapist perceptions, although therapists' views were influenced by client ethnicity. There was no difference between gender or ethnicity matches on perception of outcome. Further examination showed that gender and ethnicity interacted to influence both client and therapist perceptions of outcome. The authors discuss the research and practice implications of these findings.     

The New Careers: A Book Review

Book reviewed in this article: The New Careers: Indiuiduat Action & Economic Change by Michael B. Arthur, Ken‐ Inkson. and Judith K. Pringle     

Traditionally Defined Client,Meet Feminist Therapist: Feminist Therapy as Attitude Change

This article explores feminist therapy within the framework of the social-psychological influence process, outcomes of feminist therapy, and some cautions about the influence process.     

The Relationship Between Momentary States of Therapist Self-Awareness and Perceptions of the Counseling Process

To investigate the role of momentary self-awareness, beginning therapists and their volunteer clients participated in a postsession process recall in which therapist helpfulness and momentary self-awareness were assessed along with client reactions. Therapist anxiety levels and strategies used to manage hindering self-awareness were also examined. Results suggest that momentary states of heightened therapist self-awareness may be hindering. Specifically, when therapists rated themselves as more self-aware from moment to moment during counseling sessions, they also rated themselves as more anxious before the session and their clients rated them as less helpful during the session. In addition, therapists reported using a variety of strategies to manage distracting self-awareness, including focusing on intervention planning and focusing on the client. Implications for therapist training are discussed.     

Natural Selection and Design: Comments on Michael Ruse's New Book

Is the adaptive complexity of living organisms the result of evolutionary processes alone? or does it give evidence of intentional design? Michael Ruse appears to argue that we can have it either way. As a scientist I find the argument from design unnecessary. Yet it has great appeal to humans, whose behavior is largely intentional and who look for patterns in events and for the intentions that may have produced them.     

The Relationship Between Counseling Trainee Perfectionism and the Working Alliance With Supervisor and Client

The relationships between perfectionism, counseling self‐efficacy, and the supervisory and client working alliance were investigated among 143 counseling trainees and 46 supervisor–trainee dyads. Maladaptive perfectionism was negatively correlated with the supervisory alliance and working alliance. Counseling self‐efficacy moderated the relationship between adaptive perfectionism and the supervisory alliance (perspective of the counseling trainee) and maladaptive perfectionism and the supervisory alliance (perspective of the supervisor). The authors conclude that supervisors should consider perfectionism and counseling self‐efficacy as important factors in supervision.     

Relationship Between Counselors' Clinical Hypotheses and Client Ratings of Counselor Effectiveness

The authors assessed the relationship of counseling students' hypothesis formation skill levels to counseling effectiveness. Hypothesis rating scales were selected to assess skill in using a comprehensive range of client data, integrating multiple client dimensions, and forming questions for hypothesis testing. Results indicated that higher ratings of hypothesis formation skill were associated with higher client ratings of counselor effectiveness. A combination of four hypothesis skill ratings predicted more than 60% of the variance in total Counselor Rating Form-Short version (CRF-S) scores, and one or more hypothesis formation skills were predictive of each CRF-S subscale score.     

Client,Treatment, and Therapist Variables Related To Outcome in Brief,Systems-Oriented Family Therapy

Client, therapist, and treatment characteristics were examined with respect to how much of the variance they could account for in a variety of outcome measures. Multiple regression analyses were used to examine relationships among each of the client, therapist, and treatment characteristics studied and the various outcome measures. For the 219 families that were treated with brief family therapy, only a relatively low amount of variance in any of the outcome measures could be accounted for. The amount of explained variance, however, varied considerably from one outcome measure to the other. When the more homogeneous groups of clients (single parents or adolescent identified patients) were considered, the amount of explained variance generally showed an increase. Different sets of client, therapist, and treatment variables accounted for the variance in these outcome measures across client groups, demonstrating both the complexities of the relationships and the relative independence of various outcome measures. New variables are suggested for future research.     

Book Review: Between Technology and Humanity: The Impact of Technology on Health Care Ethics

Theoretical Medicine and Bioethics -