Client‐centred group therapy for survivors of interpersonal trauma: A pilot investigation

Group therapy for trauma survivors provides an opportunity to share experiences with others in a supportive environment. Client‐centred groups have received very little attention as a way of working with traumatised people. Such groups promise to promote psychological growth following trauma. In this paper we present pilot data from a client‐centred group of six survivors of interpersonal violence who were experiencing complex posttraumatic stress reactions. Results suggested that those who perceived the presence of empathic listening within the group therapy sessions benefited from the group, showing greater positive changes. Clinical implications for working with trauma survivors, methodological considerations and directions for future research are discussed.     

The impact of Christian counselling on survivors of sexual abuse

The absence of research and growing involvement of Christians in all areas of counselling gave rise to this study which explores the impact of Christian counselling on adult survivors of sexual abuse. The sample of 44 women and 5 men from an inter-denominational, self-help network, completed a self-report questionnaire of perceived Christian and professional counselling experiences involving issues of trust, power, directive approach, use of prayer and Scripture, responsibility and outcome. Results show that Christian counselling is experienced as qualitatively different from professional counselling: Christian counsellors are perceived as significantly more directive and more powerful than professional counsellors and the overall outcome was perceived more negatively. A number of key factors were identified which influenced the negative experience of some Christian counselling. These included having experience of professional counselling, an emphasis on the use of prayer and Scripture, perceiving the counsellor to have different goals from the client, feeling blamed for continued distress and having prior experience of prayer ministry. Implications for counselling practice and training are discussed.     

The relationship between counsellor interpersonal skills and the core conditions of client-centred counselling

The present study aimed to determine whether there was a systematic relationship between Rogers'(1957) core conditions of empathy, acceptance and genuineness, and counsellors' use of specific behaviours or skills which have been isolated for training. Video recordings of 12 counsellors' performance in 'naturalistic' counselling interactions were analysed. Counsellor, client and judges' ratings of the core conditions were obtained. Skill assessment included molar ratings of eight skill areas and molecular measures of 29 behaviours. The results indicated that there were few significant relationships. It is concluded that there is a discrepancy between specification of the skills or behaviours which are thought to communicate the core conditions and those which have been empirically demonstrated to do so. Implications for counsellor training and proposals for future research are discussed.     

Cultural landscapes in counselling and psychotherapy: Introduction to the Theme Section

The concept of ‘culture’ is gaining in significance within the discourse of counselling and psychotherapy, as a means of making sense of the ways in which shared identities and behaviours are constructed and maintained. The selection of papers included within this Theme Section explore different aspects of the use of the idea of culture within counselling and psychotherapy. In this introductory piece, we seek to place this work in a social and professional context.     

A peocess model of ethnocultural counselling for African survivors of organized violence

By analysing some 500 counselling and psychotherapy cases of survivors of organized violence as a therapist and supervisor over ten years the author developed a heuristic framework for a process model of ethnocultural counselling considering: (1) African counsellor's indigenous concepts, (2) a WHO-UNHCR approach, (3) a heuristic approach to psychotherapy, (4) a constructive narrative perspective, (5) an ethnopsychotherapeutic approach, and (6) a counselling approach for lay counsellors. The counselling process model comprises the following components: (1) Establishing a counselling relationship and motivation for change; (2) defining the problem, explanatory models, goals, and finding interventional means; (3) social comparison, cognitive undoing, metaphors, shared experiences and relaxation techniques; (4) working through the trauma, testimony approach; (5) ritualistic, cognitive and supportive approaches; (6) principle of education and advice; (7) evaluating and revizing treatment and stabilizing behaviour. These seven counselling components are described and counselling case examples are provided from Sudanese refugees in a large camp in Uganda and Malawian torture survivors in Malawi.     

Treating survivors of war trauma and torture.

Psychologists are in a unique position to assist individuals and groups in the world who have survived torture and war trauma. Symptoms of posttraumatic stress disorder and other psychological diagnoses can be treated effectively by mental health professionals and trained lay counselors in the smallest of communities in the world. This article proposes a model for the treatment of survivors of torture and war trauma. This model has been designed to be useful to mental health professionals and to lay individuals in communities who constitute the front line in treatment: health providers, midwives, ministers, and teachers. The model is presented through examples of its use in the training of mental health counselors in the United States and in the training of promotores (health promoters) and comodrones (midwives) in Guatemala.     

Prior interpersonal trauma: the contribution to current PTSD symptoms in female rape victims

The purpose of the current study was to disentangle the relationship of childhood sexual abuse and childhood physical abuse from prior adult sexual and physical victimization in predicting current posttraumatic stress disorder (PTSD) symptoms in recent rape victims. The participants were a community sample of 117 adult rape victims assessed within 1 month of a recent index rape for a history of child sexual abuse, child physical abuse, other adult sexual and physical victimization, and current PTSD symptoms. Results from path analyses showed that a history of child sexual abuse seems to increase vulnerability for adult sexual and physical victimization and appears to contribute to current PTSD symptoms within the cumulative context of other adult trauma.     

Posttraumatic growth in trauma survivors: Implications for practice

The study of positive sequelae to trauma is increasingly a focus of attention in the trauma research literature. This paper describes the construct of posttraumatic growth, a phenomenon that involves positive changes and benefits gained through coping with traumatic experiences. Variables associated with posttraumatic growth are summarized. Specific interventions for counselling psychology practice are described.     

Informed consent content in research with survivors of psychological trauma

One hundred eighty trauma-focused dissertations published in the United States were examined to determine the variation in risk language used in the informed consents. Level of risk proposed in the informed consents was poorly related to ratings of risk by graduate coders and virtually unrelated to vulnerability factors such as the age of participants and clinical or nonclinical status. Risk language in the informed consents was markedly elevated over that rated by the coders, with more than one third of the dissertations presenting the risk of participation as severe (i.e., associated with substantial risk of reactivity and lasting discomfort). These statements are not in keeping with the literature and raise ethical concerns in relation to (a) nocebo effects, (b) distortion of correlational findings, and (c) discouragement of participants from disclosing trauma in other settings.     

Vicarious trauma: The psychological impact of working with survivors of trauma for South African psychologists

Traumatic events are highly prevalent in South African society and psychologists who work with survivors of trauma have been identified as particularly at risk of being adversely affected by their work, and experiencing vicarious trauma. This study aimed to explore the experiences of a group of South African psychologists who work predominantly with trauma survivors. Individual semi-structured interviews were conducted with six psychologists (females = 67%). The predominant type of trauma encountered by participants in clinical practice was interpersonal trauma in the form of physical and sexual abuse (83%). Data were analysed using thematic analysis. All participants reported symptoms of vicarious trauma including disruption in cognitive schemas, symptoms characteristic of post-traumatic stress disorder, and somatic symptoms. Participants also reported vicarious post-traumatic growth including an enhanced sense of interpersonal connectedness and positive changes in their philosophy of life and self-perceptions. The findings serve to sensitise psychologists to the impact of working with trauma survivors so as to enhance the efficiency of psychological service delivery to traumatised populations.     

Introduction to the Special Section ‘Innovative counselling and psychotherapy research methods’: Defining the future of counselling and psychotherapy research

In the call for papers for this Special Issue, we sought submissions that would introduce innovative methods with the potential to shape counselling and psychotherapy research into the future. We believe that we accomplished this goal and that this issue introduces a range of valuable examples of current innovations in counselling and psychotherapy research methods. Through the review process, we encouraged authors to offer practical guidelines on how to innovatively assess and analyse change and other relevant aspects of therapy. We also guided authors to not only provide the field with an update on cutting‐edge methodology, but also describe these methods in a practice‐friendly way. As such, the Special Issue aims at becoming a building block for future practice‐friendly research in counselling and psychotherapy.     

Emotion regulation difficulties in trauma survivors: the role of trauma type and PTSD symptom severity

Two different hypotheses regarding the relationship between emotion regulation and PTSD are described in the literature. First, it has been suggested that emotion regulation difficulties are part of the complex sequelae of early-onset chronic interpersonal trauma and less common following late-onset or single-event traumas. Second, PTSD in general has been suggested to be related to emotion regulation difficulties. Bringing these two lines of research together, the current study aimed to investigate the role of trauma type and PTSD symptom severity on emotion regulation difficulties in a large sample of trauma survivors (N=616). In line with the hypotheses, PTSD symptom severity was significantly associated with all variables assessing emotion regulation difficulties. In addition, survivors of early-onset chronic interpersonal trauma showed higher scores on these measures than survivors of single-event and/or late-onset traumas. However, when controlling for PTSD symptom severity, the group differences only remained significant for 2 out of 9 variables. The most robust findings were found for the variable "lack of clarity of emotions." Implications for future research, theoretical models of trauma-related disorders, and their treatment will be discussed.     

Hopelessness as a risk factor for post-traumatic stress disorder symptoms among interpersonal violence survivors

Post-traumatic stress disorder often co-occurs with depression, and they may share common risk factors. One possible common cognitive risk factor is hopelessness. Thus, we examined whether hopelessness was related to symptoms of post-traumatic stress disorder. Participants were 202 female survivors of interpersonal violence. Relationships between self-reported and interviewer-rated measures of hopelessness gathered at 2 weeks post-trauma and self-reported and interviewer-rated symptoms of post-traumatic stress disorder gathered at 2 weeks and 3 months post-trauma were examined. Hierarchical, simultaneous regression analyses that co-varied trauma type revealed that hopelessness was related to self-reported symptoms of post-traumatic stress disorder, both concurrently and prospectively. Follow-up analyses revealed that relationships between hopelessness and symptoms of post-traumatic stress disorder were due almost entirely to shared variance with depression. No relationships were found between hopelessness and interviewer-rated symptoms of post-traumatic stress disorder.     

Psychological trauma reconsidered: Overview and proposed psychotherapy for survivors

Abstract

This paper attempts to establish a conceptual approach to the etiology of psychological trauma. The literature on the subject of the impact of trauma–particularly on the coherent sense of self and effective ego functioning–is reviewed. The case of a young victim of trauma is included to exemplify hew the disruption of social relationships and their internal cognitive representations, through abuse, exploitation, and other acts of unpredictable trauma, can interfere with the normal functioning of personality in the posttraumatic state until an appropriate therapeutic intervention or experience occurs. A construct for the psychotherapy treatment of trauma is suggested.     

Introduction to the special series on integrating personality, psychopathology, and psychotherapy using interpersonal assessment

The interpersonal paradigm in personality assessment employs multiple models, measures, and methods to examine the interpenetration of personality, psychopathology, and psychotherapy. Its organizing framework is the nomological net of agency and communion, which are fundamental metaconstructs that can be conceptualized and measured at multiple levels ranging from broad interpersonal motives to stable interpersonal dispositions to specific interpersonal behaviors. This Special Series presents diverse research and clinical applications of interpersonal theory and assessment to (a) enhance diagnosis, case conceptualization, and treatment planning; (b) identify developmental catalysts of and current influences on psychopathological symptoms; and (c) articulate different ways in which personality, psychopathology, and psychotherapy are interrelated. Each article demonstrates the integrative nature of interpersonal assessment while concurrently exemplifying the unique assumptions and methods of contemporary interpersonal diagnosis.     

Facilitated and real trauma in the psychoanalysis of children of Holocaust survivors

The author investigates the effect of retraumatization on the children of Holocaust survivors who have appropriated their parents' trauma through unconscious identification. The author proposes that the working through of the real trauma results in a mitigation of the transmitted trauma in the psychic reality and mobilizes the work of mourning that facilitates the mastery of the real as well as the transmitted trauma. Two case examples are cited as illustration.