Chinese indigenous psychotherapies in Singapore

The purpose of this paper is to discuss the relevance of folk therapies or traditional medicine to counselling in Singapore. It addresses the meanings of the indigenous psychotherapies and then the rationales for understanding them. Three popular Chinese indigenous psychotherapies have been selected for discussion in terms of their aetiology and treatment beliefs about emotional problems: traditional Chinese medicine, dang‐ki (Chinese shamanism), and feng‐shui (Chinese geomancy). Findings from an empirical study are briefly presented to show that Chinese Singaporean clients hold eclectic belief systems encompassing both beliefs derived from thse indigenous psychotherapies and those from Western psychotherapies (e.g. psychodynamic and behavioural therapies). Two cases are presented to illustrate the application of these indigenous psychotherapies in counselling practice.     

Clients' beliefs about psychological problems

An investigation of clients beliefs about the causes and treatments of their own psychological problems, using a new instrument, the Opinions about Psychological Problems (OPP). We found that, although the beliefs about the various models were positively correlated, clients made clear overall discriminations between them. For causation, they tended to agree with the four psychological models (Behavioural, Cognitive, Humanistic and Psychodynamic) and the Naïve model, and tended to disagree with the Socio-economic and Organic models. For treatment, they endorsed Behavioural, Cognitive and Humanistic most highly, and again disagreed overall with Socio-economic and Organic. Individual difference variables showed that clients reporting a higher level of psychological symptoms tended to endorse all causation beliefs more highly, and also were more likely to agree with Behavioural, Cognitive, Humanistic and Psychodynamic treatments. The structure of clients' beliefs differed from that found in previous studies. There was a single factor which loaded on the four psychological models, with which the Organic, Socio-economic and Naive subscales were less strongly, but still positively, correlated     

Filial belief and parent-child conflict

This study examines the relation between filial belief and the frequency, origins, and solutions to parent‐child conflict using an indigenous Chinese perspective. The Dual Filial Piety model is employed to categorize the four types of filial belief: nonfilial, authoritarian, reciprocal, and absolute. Questionnaires were completed by 773 junior and senior high school students from around Taiwan for the study. Results provided support for the indigenous Chinese notion that a child's filial beliefs relate to the level of parent‐child conflict. The results go beyond this common conception to highlight that filial beliefs may have a particular role in decreasing self‐centred but not inappropriate conflict between parents and children, and that reciprocal filial beliefs may have a more important role in decreasing conflict than authoritarian filial beliefs. Clear differences were identified in the reported origins of conflict (Demands Conflict with Desire. Unreasonable Behaviour, Demand Exceeds Ability, Role Conflict, Interparental Dispute. Immoral Demands) and solutions to conflict (self‐sacrifice, compromise, refraining, ego‐centred, escape) among the four filial types. Parent demands conflicting with the child's desire was the greatest source of conflict for each of the four filial types. Nonfilial types reported significantly more conflict than absolute types for four of the six origins of conflict examined. Low incidence of conflict may explain why the filial types did not differ for the remaining two origins. Overall, the four filial types reported self‐sacrifice as their least used solution to parent‐child conflict, and nonfilials reported significantly less use of this solution than the other three filial types. Absolutes and reciprocals reported significantly more use of refraining than the other two filial types. Results of this study provide the first empirical support for the Dual Filial Piety model and constitute a foundation for continued indigenous research on parent‐child relations in Chinese culture. It is expected that an indigenous theory of parent‐child relations incorporating the Dual Filial Piety model can eventually be integrated into a global psychology.     

General belief in a just world and resilience: Evidence from a collectivistic culture

Previous research showed that in the individualistic culture, adults endorse the personal more than the general belief in a just world (PBJW vs. GBJW). Comparatively little is known about the prevalence character and adaptive functions of GBJW, especially in the collectivistic culture. We conducted three surveys among the Chinese adults and adolescents. We found that (1) Chinese adults and adolescents endorsed more GBJW than PBJW; (2) Adult survivors with high exposure to post‐earthquake trauma and adolescents in the poverty‐stricken area maintained high GBJW, with relatively lower PBJW. (3) GBJW predicted the psychological resilience in all the three samples independent of PBJW. The results imply that in contrast to populations from the individualistic culture, people from the collectivistic culture endorse a robust GBJW, which allows them to resiliently confront harsh realities. Copyright © 2010 John Wiley & Sons, Ltd.     

The stalking of psychotherapists by current or former clients: Beware of the insecurely attached!

Abstract

A survey of psychological therapists who worked in primary care showed that the incidence of psychotherapists being harassed or stalked by their current or former clients was more than twice the national average at 24%. The stalkers fell into three broad categories: those clients who were needy and made early attachments to their therapists; those experiencing erotic transference; and those with personality disorders, especially those with a narcissistic style. All of these are disorders of attachment. This paper discusses the neurobiological development of an insecure attachment and how that manifests during therapy in stalking behaviour. Psychotherapists who are aware of the dynamics within the therapeutic relationship can take preventative steps to inhibit the automatic fear response of a client who is insecurely attached and which may lead to stalking behaviour.

A survey of psychological therapists who worked in primary care showed that the incidence of psychotherapists being harassed or stalked by their current or former clients was more than twice the national average at 24%. The stalkers fell into three broad categories: those clients who were needy and made early attachments to their therapists; those experiencing erotic transference; and those with personality disorders, especially those with a narcissistic style. All of these are disorders of attachment. This paper discusses the neurobiological development of an insecure attachment and how that manifests during therapy in stalking behaviour. Psychotherapists who are aware of the dynamics within the therapeutic relationship can take preventative steps to inhibit the automatic fear response of a client who is insecurely attached and which may lead to stalking behaviour.     

灾区民众的公正观与幸福感及其与非灾区的比较

作为公德的社会公正与作为私情的个人幸福,是个体作为社会成员的两个方面,二者在逻辑上是统一的,以往的心理学研究也证实了这一点,但在低标准下,二者却可能出现分离。本研究探讨了灾区民众的公正观和幸福感及其与非灾区的对比,以及中国本土文化背景下二者的关系。本研究发现,与非灾区相比,处在灾区的民众持有更高的公正观与更平和的情感状态,男性尤其如此,并且其情感幸福对公正观有微弱的正向预测（主要是积极情感）,但八个月后随着公正观与幸福感的回落,这种关联变得不显著。民众的情感幸福与公正观在常态下表现为分离的关系,但生活满意度这一幸福感的认知因素却与公正观一直有正向的关联。总之,情感幸福、认知幸福与社会认知的矛盾、变换关系,暗示了建立在私情基础之上的、在灾难中不断强化的中国人特定的情感与理性诉求。     

Three Aspects of the Therapeutic Conversation in Couples Therapy

Abstract

Feminist scholars have revealed the importance of examining the influence of gender on the therapeutic process. Gender differences in the treatment of clients may reveal inequitable or traditionally Stereotypie treatment of clients by therapists. This study examined gender differences in three conversational strategies widely used by therapists: expressions of empathy or understanding, compliments or praise, and challenges or requests for change. Fourteen tapes of live therapy sessions conducted by “master” therapists were examined using an exploratory, qualitative methodology based on Conversation Analysis. Results of this exploration revealed that therapists who are not self identified as “feminist challenged female clients more than male clients, and complimented male clients more than female clients. Feminist therapists challenged male clients more than female clients, and complimented female clients more than male clients. Feminist therapists used more challenges designed to facilitate non-stereo-typic gender behavior in both male and female clients. Only male therapists used disrespectful challenges of female clients, and were more often disrespectful to female clients than to male clients. Implications for the therapist-client relationship and the feminist critique are provided.     

Just for Women? Feminist Multicultural Therapy with Male Clients

Feminist multicultural therapy is an integrative approach to psychotherapy that emphasizes a systems-level understanding of psychological distress and the process of therapeutic change. In the present exploratory study, the experiences of feminist multicultural therapists working with male clients were studied using Consensual Qualitative Research (CQR) (Hill et al. 1997). Phone interviews were conducted with eight female practicing licensed or license-eligible therapists who had worked with at least one male client in the past 6 months. Consistent with the theoretical approach, all of the therapists interviewed expressed their belief that psychological symptoms can be seen as a reaction to a loss of power or related to the effects of an oppressive system. Additionally, the therapists believed that this theoretical model is broad enough to be used with varying types of intersecting social identities. The findings illustrate the ways in which the counseling approach may work similarly across genders, as well as ways in which one’s therapeutic approach may be altered when working specifically with men. Implications for therapists who work with male clients (both the rewards and the challenges) as well as for researchers who wish to study the application of therapeutic interventions with men are discussed.     

The prevalence of stalking of psychological therapists working in primary care by current or former clients

The prevalence of being a victim of harassment or stalking among the general population of the UK is held to be 11.8 per cent. There has been speculation that the prevalence rate would be higher for psychological therapists, as they could be at risk from their own clients. This study analysed the prevalence of job‐related experiences of harassment or stalking in a postal survey of psychological therapists who worked in primary care. The results showed a prevalence rate of more than twice the national average at 24 per cent. The stalkers, who were equally male or female, fell into three broad categories: those clients who were needy and made early attachments to their therapists; those experiencing erotic transference; and those with personality disorders. The implications of these findings for training and practice are discussed.     

Cultural Influences in the Aetiological Beliefs of Saudi Arabian Primary Care Patients About Their Symptoms: The Association of Religious and Psychological Beliefs

Objective To develop a self-report questionnaire to measure the beliefs of Arabic primary care patients about the causes of their physical symptoms; to use this to quantify the beliefs of patients consulting their general practitioners (GPs) in Saudi Arabia; and to test whether patients with psychological problems differ from others in their beliefs, particularly religious and supernatural beliefs. Methods Consecutive patients (N = 224) completed a specially developed aetiological beliefs’ questionnaire. Patients were divided into two groups (cases and non-cases of emotional disorder) according to the GHQ-12. Results Religious and supernatural aspects of culture colour patients’ symptom beliefs: that their symptoms were a test or punishment from Allah’ was the most common belief. Even in non-cases, around half the patients also endorsed nerves and stress as a cause of their physical symptoms. Cases were more likely than non-cases to endorse items related to both religious and psychological factors. Conclusion There is no support for the view that Saudi Arabian patients explain symptoms supernaturally as a way of denying psychological factors. GPs and health professionals in Saudi primary care need to understand what patients believe to be the cause of their problems and to appreciate that religious and psychological beliefs are both very common. GPs should address psychological beliefs and concerns even with those patients who present physical symptoms.     

When 2–3% really matters: The (un)importance of religiosity in psychotherapy

Previous research suggests that clients’ religious beliefs are commonly excluded from therapeutic practice. Often, this exclusion is attributed to practitioners’ lack of knowledge or appropriate skills. Such analyses, however, have little regard for the interactional aspects of the therapist/client encounter. Drawing upon work within discursive social psychology, we argue that the exclusion of religious beliefs does not reflect therapists’ lack of knowledge or awareness but can more usefully be seen as the discursive accomplishment of marginalizing clients’ beliefs. Six practising psychotherapists were interviewed about religious beliefs within the therapeutic process. Participants construct religious beliefs as important but relevant only to restricted categories of clients. They rework religious beliefs as compatible with accepted practice, or construct particular groups of clients as incompatible with the process. Training and other requirements are reformulated in terms of spiritual beliefs rather than religious beliefs. These constructions display awareness of religious beliefs while marginalizing their relevance in practice. Inclusion of clients’ religious beliefs to best effect will require more psychotherapy to engage more constructively with religion than it does at present.     

The generality of belief in unsubstantiated claims

We tested the hypothesis that people show generality in their endorsement of unsubstantiated claims, employing more types of measures than used in previous studies. We found that measures of generic conspiracist ideation, specific fictitious conspiracy theory, and false conspiracy theory beliefs were all strongly and positively intercorrelated. A multiple regression analysis revealed that the measures of specific false and fictitious conspiracy theories both significantly predicted generic conspiracist ideation. A second broader test of the generality hypothesis showed that these measures of false and fictitious conspiracy belief were positively intercorrelated with measures of psychological misconceptions, pseudoscience, poorly supported psychological practices, and paranormal beliefs. However, the measures of misconceptions and pseudoscience displayed substantially lower correlations. The results provide support for the generality of acceptance of a wider variety of unsubstantiated claims than used in previous studies and also suggest differences in the types endorsed based on the kind of knowledge and content measured.     

Beliefs about stories: Parents' and therapists' explanations of childhood difficulties

Therapists and parents were given vignettes describing the behavioural and emotional difficulties of two nine-year-old children and were asked to rate the importance of a number of possible explanations for such difficulties. Broad agreement was found between parents and therapists, but also there were a number of significant differences. Parents endorsed more child centered explanations and put greater emphasis on physical and developmental factors, while therapists endorsed relationships factors and saw the beliefs of other family members as important. Therapists who were parents showed a pattern of responses that lay between those of parents and non-parent therapists.     

Maternal Beliefs,Adolescent Perceived Maternal Control and Psychological Competence in Poor Chinese Female-Headed Divorced Families

Based on the data of 337 female-headed divorced families living in poverty in Hong Kong, the relationships among maternal beliefs (Chinese cultural beliefs of familism, maternal expectations of children’s future, maternal attribute of children’s achievement to effort), adolescents’ perceived maternal control and adolescent psychological competence (indexed by beliefs in the future, clear and positive identity, and resilience) were examined. Results indicated that adolescents’ perceived maternal control mediated the influence between maternal beliefs and adolescent psychological competence in poor female-headed divorced families in Hong Kong. With the paucity of research on family beliefs and indigenous parenting practice, the present study underscores the importance of maternal beliefs and maternal control on nurturing adolescent psychological competence in Chinese divorced families facing adversity, which contributes to the development of Chinese familial model of resilience. Theoretical and practical implications of the findings are discussed.     

Sexual Prejudice Among Heterosexual College Men as a Predictor of Condom Attitudes

Heterosexual male college students (N?=?100) (average age?=?19.7; 43% European American; 39% Christian) from the southwestern U.S. completed surveys in order to test a model predicting condom attitudes from religiosity, gender role attitudes, sexual prejudice, and the belief that “AIDS is a gay disease.” In the final model, those who reported more religiosity, more traditional gender role attitudes, and greater anxiety about interacting with gay men also reported feeling their core values and beliefs were threatened by gay men. In turn, men who felt strongly threatened in this way more strongly endorsed the belief that “AIDS is a gay disease,” and stronger endorsement of this belief was associated with more negative attitudes about condoms and condom use.     

Developing Cross-Cultural Competence with Traditional Chinese Americans in Family Therapy: Background Information and the Initial Therapeutic Contact

This paper presents an overview of Chinese American history, cultural values, family dynamics, traditional beliefs concerning psychological and interpersonal problems, and help seeking behaviors. Recommendations are given to family therapists in making initial contact with the more traditionally-oriented Chinese Americans.     

Are "obsessive" beliefs specific to OCD?: a comparison across anxiety disorders

Cognitive models of obsessive-compulsive disorder (OCD) assign a central role to maladaptive beliefs about threat, uncertainty, importance and control of thoughts, responsibility, and perfection. Previous research has demonstrated that such beliefs relate to specific OCD symptoms in a theoretically meaningful way. The aim of the present study was to determine whether these beliefs are endorsed more strongly by OCD patients than by those with other anxiety disorders. Eighty-nine adult OCD patients, 72 anxious control (AC) patients, and 33 nonclinical control (NCC) participants completed a measure of obsessive beliefs as well as measures of depression and trait anxiety. Compared to NCCs and ACs, OCD patients more strongly endorsed beliefs related to threat estimation, tolerance of uncertainty, importance and control of thoughts, and perfectionism, but not inflated responsibility. Using revised, condensed subscales, OCD patients differed from ACs on beliefs about perfectionism and certainty and about importance and control of thoughts, but not on beliefs about threat estimation and inflated responsibility. When controlling for depression and trait anxiety, the OCD and AC group did not differ on most belief domains, except for a belief that it is possible and necessary to control one's thoughts. Results are discussed in light of evolving cognitive-behavioral theories that highlight appraisals of thought control and the use and effectiveness of varying thought control strategies.     

Clients’ perceptions of personal psychotherapy or counselling for therapists

The purpose of this study was to examine clients’ opinions of therapists’ personal use of psychotherapy or counselling. Participants in this study, a nationwide sample of clients recruited through Amazon’s MTurk system, were asked to complete an online survey assessing their attitudes towards treatment use by therapists as well as their general attitudes towards psychological help-seeking and perceptions of stigma (social and self) with psychological treatments. In this study, we found that clients generally had positive views about therapists’ personal use of psychotherapy or counselling. Although overall positive attitudes were found, the results from repeated measures ANOVAs indicated that attitudes depended somewhat on whether the therapist had sought out treatment as part of a training requirement for self-enrichment, or for the treatment of a psychological problem. In addition, participating clients were less supportive of therapists disclosing a treatment use history with their clients. Regression analyses also indicated that attitudes towards treatment use by therapists were significantly predicted by general help-seeking attitudes and perceptions of stigma (social and self), but attitudes towards disclosure were not. The findings from this study have important implications regarding therapist treatment use and disclosure in practice.     

The therapeutic relationship in Rational-Emotive Therapy: Some preliminary data

This study assessed the therapeutic relationship between psychotherapy clients and Albert Ellis and other Rational-Emotive Therapists. Clients at the Institute for Rational-Emotive Therapy completed the relationship questionnaire (Truax, & Carkhuff, 1967). The results suggest that RET therapists do develop positive therapeutic relationships. Clients receiving RET endorsed significantly higher scores on most therapeutic relationship subscales compared to subjects in the initial articles introducing the therapeutic relationship scale. There were no differences in therapeutic relationship scores by gender of the therapist. Also, there was no correlation between the relationship scores and the number of sessions completed, which suggests the therapuetic relationship develops early. Both clients of senior and junior therapists received higher relationship scores than did clients of Dr. Ellis. This disconfirms the argument that RET practices cannot lead to a therapuetic relationship and Ellis' therapeutic relationship is a result of his fame and could not be duplicated by other therapists using RET.The authors wish to thank the Board of Trustees of Institute for Rational-Emotive Therapy for their financial support of this study.     

Ayahuasca in Western society and the metacognitive counselling approach

Ayahuasca is a hallucinogenic plant used throughout South America for religious, cultural and healing ceremonies. Previous studies have analysed it as a therapy method from either the microperspective, such as physiological and psychological effects of substance use, or the macroperspective, such as legal issues or cultural appropriation of ayahuasca by Westerners. There is a need to combine those two aspects to fully understand the effects of ayahuasca for therapists and clients in Western communities. By utilising an autoethnographic instrumental case study, we discuss the possible risk of ayahuasca gaining popularity in Western societies without an understanding of how the social context plays a tremendous part in healing using this method. We also discuss the risk of intrapsychic experiences brought about by ayahuasca that may deter individuals from seeking appropriate treatment. It is not our intention to present ayahuasca as an illegitimate or invalid method of healing; rather, we emphasise the importance of integrating micro- and macroperspectives in psychotherapy practice. We suggest that the metacognitive counselling approach be taken by both clients and therapists when adopting indigenous methods of therapy which may add a significantly positive effect. Although we hope this study offers realistic and lived experiences to generate pragmatic solutions for therapists and clients, we recognise that it is necessary to collect data from a larger number of both clients and therapists to better support our suggestion of the metacognitive counselling approach.