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.     

Psychotherapists' religious beliefs and their perception of the psychotherapy process

In a comparison of religious and nonreligious psychotherapists' perceptions of a portion of a psychotherapeutic session no significant differences were found on the Vanderbilt Psychotherapy Process Scale for four groups of therapists designated according to their scores on three religious questionnaires. While the results suggest attitudes toward religion are not reflected in therapists' practice of psychotherapy, limitations of the study indicate the need for more rigorous testing of this possibility.     

Integrating Spirituality and Religion Into Psychotherapy: Persistent Dilemmas,Ethical Issues,and a Proposed Decision-Making Process

Religion and spirituality are important aspects of the lives of most psychotherapy clients. Unfortunately, many psychotherapists lack the training to effectively and ethically address these issues with their clients. At times, religious or spiritual concerns may be relevant to the reasons clients seek treatment, either as areas of conflict or distress for clients or as sources of strength and support that the psychotherapist may access to enhance the benefit of psychotherapy. This article reviews persistent ethical issues and dilemmas relevant to providing psychotherapy to clients for whom issues of religion and spirituality are clinically relevant. Ethical considerations include assessment, advertising and public statements, informed consent, competence, boundary issues and multiple relationships, cooperation with other professionals, and how to effectively integrate religious and spiritual interventions into ongoing psychotherapy. A decision-making process is presented to guide psychotherapists in their clinical work with clients for whom religious and spiritual issues are salient or clearly linked to their presenting problems.     

A developmentally keyed scheme for the placement of gay men into psychotherapy groups

Patients can meet their needs for intimacy and individuation within the context of long-term psychotherapy groups. This is especially true for gay male patients as they work toward the development of a positive gay identity. Coming out is a social phenomenon, which is why groups are especially suited to the tasks involved. Historically, mixed groups of gay and nongay men and women have not been a safe or neutral treatment atmosphere for gay men due to therapists' prejudicial assumptions and a lack of understanding of gay male development. A developmental scheme will be presented which is keyed to the particular needs of gay men depending on their developmental stage of functioning. This scheme should serve as a more rational and appropriate guide for the diagnosis, treatment planning, and assigning of gay men to long-term psychotherapy groups.     

Treatment of the chronically mentally ill: an opportunity for the group therapist

This article focuses on the therapist's task of engagement in the group treatment of the chronic mentally ill. The dynamics of individual and group processes are reviewed with an emphasis on the contributions of social, interpersonal, and intrapsychic factors. Drawing upon the observations of Friedman (1988), the presentation explores therapists' efforts to restore their inner balance by (1) acting like a therapist, that is, according to their theory; (2) satisfying their curiosity; and (3) eliciting "something desirable," which is formulated as the therapist's search for interactive responses. Examples illustrate these elements as they emerge in group psychotherapy.     

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.     

CHRISTIAN HUMANISM AND PSYCHOTHERAPY: A RESPONSE TO BERGIN'S ANTITHESES

Abstract. Secular and religious values of psychotherapists influence the process of psychotherapy. The psychologist Allen Bergin has pointed out several major antitheses between values of secular psychotherapists and their religiously oriented clients. The present essay is a response to Bergin's antitheses, on the one hand, and to humanistic psychology, on the other, from the point of view of a Christian humanism. Karl Rahner's theological anthropology is proposed as one possible foundation for an explicit articulation of the relationship between psychotherapy and religion, and as a means to address apparently divergent values of psychotherapists and religious believers.     

Bridging the Divide

Abstract

Women who consider themselves traditional or conservative in the context of religious practice often experience tremendous conflicts regarding the integration of same-sex emotional and sexual feelings with their religion and spirituality. Current religious teachings about homosexuality make this combination difficult as only heterosexual sexuality within marriage is permitted in most orthodox faiths. Further, the way that spirituality and sexuality are conceptualized as opposing dichotomous categories (e.g., body vs. soul) presents women with a framework where integration does not seem possible. Observant women who come to psychotherapy often experience tremendous distress, guilt, depression, and even suicidality due to the conflict between their sexual feelings and religious doctrine. Relieving the distress, and resolving the conflicts while honoring the emotional complexity of sexual feelings, spirituality, and religious orthodoxy can present tremendous dilemmas for the practitioner as well as the client. Using the example of psychotherapy of an Orthodox Jewish woman who integrated same-sex desire into her life, this article describes psychotherapy process and alternative ways of viewing spirituality and sexuality that permit possible resolutions for clients.     

Healthy and unhealthy forms of religiousness manifested by psychotherapy clients: An empirical investigation

This study investigated whether 49 Mormon psychotherapy clients and 51 Mormon nonclients differed on a number of religious and psychological variables. The data were analyzed using analysis of covariance, controlling for social desirability, education level, and occupation status. Clients scored higher than nonclients on shame and lower on existential well-being. There were no significant differences between clients and nonclients on religious orientation, religious wellbeing, moral reasoning, and guilt. Females scored much higher on guilt, and female clients scored much higher on shame; there were no other gender differences. Subjects showed a preference for Stage 4 moral reasoning, and 92% were intrinsically motivated in their religious worship. The psychotherapy clients' religious beliefs and motivations appeared healthy and functional and could be an asset during therapy. The clients manifested some psychological issues which could predispose them to unhealthy reactions to some of the doctrines and influences of their religion. The gender differences observed were also discussed.     

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.     

Countertransference in group psychotherapy

This paper attempts to up-date our understanding of countertransference in the therapy group setting. After a brief review of some of the psychoanalytic and the group psychotherapy literature dealing with countertransference, the paper points out the vulnerability of the group therapist and presents examples of possible countertransferential situations, such as stereotyped roles, reactions to external aspects of patients, and therapists' insecurities. It concludes by suggesting ways in which group therapists can become more sensitive to their countertransferences.     

What is the Place of Clinicians’ Religious or Spiritual Commitments in Psychotherapy? A Virtues-Based Perspective

Value neutrality in psychotherapy is widely acknowledged to be a myth, and a majority of US physicians report that their religious faith influences their practice. Most attention to therapists’ religious and spiritual commitments has focused on ethical boundaries, transference/countertransference dynamics and questions about how to relate religious and psychological truth. No consensus exists about the legitimate place in psychotherapy of clinicians’ differing value commitments. Therapists’ virtues are vitally important in psychotherapy, not least in the relational and aspirational process by which the patient identifies with the therapist as they engage together in confronting obstacles which the patient has been unable to surmount alone. Among the individual and cultural factors that shape a therapist’s virtues are spiritual traditions, which encourage preferred or characteristic virtues. Arguably, these include for Jews, communal responsibility and critical thought; for Christians, love and grace; for Muslims, reverence and obedience; for Buddhists, equanimity and compassion; for Hindus, appreciation of Dharma and Karma; and for secularists, respect for scientific evidence and intelligibility. These have differing implications for treatment, as illustrated through the use of a hypothetical case. Attention to differing spiritual and religious virtues in a pluralistic culture offers opportunities for creative dialogue, collaborative teaching and interdisciplinary research.     

Group process and the catholic rites of reconciliation

While individual and group psychotherapy are often referred to as forms of secular confession, the relationship of early religious confessional practices to the psychology of contemporary helping group processes needs further exploration. An examination of the theology and form of the Catholic rites of reconciliation indicates that their psychology and structure clearly parallel many of the healing processes at work in group psychotherapy.     

Client Perspectives on Spirituality in the Therapeutic Relationship

There has been increasing interest in the integration of spirituality into psychotherapy in the last 10 years, yet we have very little in-depth information about clients' perspectives on spirituality in the counseling relationship to help guide this integration. Using a narrative methodology to explore the counseling experiences of 12 spiritually-committed clients in detail, this study suggests that clients who may not identify as traditionally religious may still view the entire process of psychotherapy through a spiritual lens. Furthermore, their spirituality may guide their interpretation of therapy, their expectations of the therapist, and their choice to engage in or terminate treatment in complex ways. By exploring the experiences of this growing breed of spiritually-committed clients, the results shed new light on the dimensions that deserve consideration as we think about how to respond to a client's spiritual needs in psychotherapy.     

WORKING WITH RELIGION: OFTEN NEGLECTED ASPECTS OF TRANSFERENCE AND COUNTERTRANSFERENCE

The author contends that psychoanalytic theory has generally presented religious beliefs as developmentally immature or pathological. This viewpoint has resulted in a neglect of religion on the part of psychoanalysts and an avoidance of their religious life by patients. Even though there has been an evolution from the traditional Freudian foundational approach to religion as an “illusion” to the inclusion of psychoanalytical training within some Christian institutes and attributions that psychoanalysis, itself, is a religion, religious beliefs should be included in psychotherapy because they can become involved in transference and countertransference issues in ways that are ignored if religious issues are not discussed in therapy. The author presents clinical material to illustrate this problem.

     

Theological and religious dimensions in pastoral psychotherapy

This article seeks to consider the theological and religious dimensions in pastoral psychotherapy. Using Erik Erikson's view of personality growth and development, the author presents a view of man as the basis for exploring the theological and religious dimensions of psychotherapy and offers five approaches to arguing for theological and religious significance in psychotherapy. The article then considers what the pastoral psychotherapist brings to this process.Dr. Jenkins is Director of Pastoral Counseling, Georgia Baptist Medical Center, 300 Boulevard, N.E., Atlanta, GA 30312. This paper was delivered to the Annual Meeting of the Southeast Region of American Association of Pastoral Counselors, October, 1980, Kanuga, North Carolina.     

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'.     

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.     

California psychologists' religiosity and psychotherapy

Forty-seven randomly selected California clinical psychologists were surveyed to examine the effect religious or spiritual orientation has on the practice of psychotherapy. This included an assessment of ideology, attitudes toward religiosity, affiliation with organized religion, dimensions of religiousness, and use of clinical interventions of a religious nature. The majority of these psychologists were found to address religious and spiritual issues in their personal lives, to respect the function religion serves in peoples' lives, and to address religious and spiritual issues in professional practice. The majority of these psychologists use interventions of a religious nature. Very limited training occurs respective of religious and spiritual concerns; 81% reported that religious or spiritual issues were rarely or never discussed in the course of their graduate education and training.This paper was presented at the annual meeting of the American Psychological Association in Los Angeles in August 1985.