A Grammar of Love

Abstract

Recently researchers in the family therapy field have encouraged a focus on aspects of therapy common across all models that are important to therapeutic change. The purpose of this study was to build on the “common factors” literature by exploring clients' perspectives of what was useful to their therapeutic experience. Quantitative and qualitative measures were used to collect data from 41 clients who participated in therapy at a university-based family therapy clinic. Quantitative results indicated that therapeutic relationship, client motivation, extratherapeutic factors, and hope and expectancy accounted for 49% of the variance of clients' perception of change and 73% of the variance of clients' perceptions of therapy helpfulness. Qualitative results indicated the therapeutic relationship to be the most helpful aspect of clients' therapeutic experience.     

“The Parallel Dialogue”: Parental experience of their role in the relationship with their child's counsellor/psychotherapist

The parent–therapist relationship is a central consideration in child counselling and psychotherapy, particularly in private practice where parents are typically financially, emotionally and practically invested in the process. The relationship, which can be ambiguous and anxiety-laden on both sides, has historically received scant attention in therapeutic discourse, leading to gaps in practitioner confidence and training. In this context, and seeking to centre parent voices, this study provides an interpretative phenomenological analysis of four mothers' experiences of their role in the relationship with their child's therapist. Key identified themes encompass parental expectation of involvement; the destabilising, disorienting nature of the relationship; the centrality of trust; and critical evaluations of value. Findings are discussed in relation to attachment theory and cultural expectations of parental responsibility. The study concludes that the relationship is a live and potent property with potential to impact the course of the intervention, and recommends that practitioners thoughtfully consider the potential benefits and drawbacks of meeting or frustrating parental involvement expectations.     

“Doc,There's Something I Have To Tell You”: Patient Disclosure to Their Psychotherapist of Unprosecuted Murder and Other Violence

The current investigation examines the incidence of clients telling their psychotherapists of committing violent crimes for which they have not been prosecuted. Thirteen percent of the psychologists surveyed indicated that on at least one occasion a client self-disclosed to them during a psychotherapy session that he/she had murdered someone, not including the killing of another person in the line of duty in the military or as a public peace officer. One third of the psychologists had clients self-disclose an unprosecuted incident of a sexual assault, and more than two thirds had clients self-disclose an unprosecuted incident of a physical assault during a psychotherapy session. Data are reported on psychotherapists' views of the impact of such disclosures on the psychotherapy relationship, adequacy of being informed regarding legal obligations after hearing such reports of violence, and adequacy of graduate preparation to deal with these clinical situations.     

How Does the Relationship Facilitate Productive Client Thinking?

My thesis is: a) that the primary client activity that facilitates change is their productive thinking, b) that one key way the therapeutic relationship is helpful is that it facilitates this kind of activity, and c) that if we look at the therapist–client dyad as a group, then we can further understand how the therapy dialogue facilitates productive client thinking through recent ideas about socially shared cognition.     

病历书写中的质量缺陷

病历书写中的质量缺陷存在于主诉、病史、体格检查、病程记录、诊断等各个方面。提高医学生病历书写质量及临床思维能力,是完成高质量病历书写的关键。同时病历书写有关的法律、法规相继出台,对病历书写提出了新的挑战。     

Pretreatment Correlates of the Therapeutic Alliance in the Chronically Depressed

We examined the relationship between patient characteristics and the working alliance in a multisite trial for chronic depression. Patients treated with the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), alone (n = 169) or combined with nefazodone (n = 198), completed the Working Alliance Inventory during the 2nd week of treatment. Within the CBASP alone group, a history of drug abuse/dependence, lower peak social adjustment over the past five years, and lower current social adjustment predicted a significantly poorer alliance. Within the combination group, male gender and a distancing coping style predicted a significantly poorer alliance. Results should be interpreted with caution since they did not replicate across treatment groups, and the number of significant findings were not much greater than chance expectations.     

Promising New Developments in the Therapist–Client Relationship: A Philosophy of Science Review and Preview

Two questions were central: What are the current and what were the past new developments in the therapist–client relationship? By means of a “philosophy of science analysis,” what principles may be taken as helping to account for these new developments? Nine principles were identified in a review, including the articles in the present theme issue of the journal. The proposal and invitation are to use these nine principles to generate further, future, promising new developments in the therapist–client relationship.     

Ethical issues in the publication of clinical material

Some of the ethical issues involved in publishing clinical material are considered. These include the 'ownership' of such material, the responsibilities of the analyst towards patients and professional colleagues, the keeping and status of records, the nature of trust and confidentiality and its place in analysis, the question of obtaining consent for publication, the nature of consent, and its consequences for treatment. The issues of disguise, of authenticity, and of accuracy are also touched on, as is the potential role of the author's anonymity in protecting the anonymity of the patient.     

心理咨询保密豁免规则的立法构建

《中华人民共和国精神卫生法》首次对心理咨询人员的保密义务做出原则性规定,与《中华人民共和国民法典》等法律规范形成了框架,但实践要求下保密豁免情形尚未形成系统性规则。基于隐私权保护和专业信任关系,探讨心理咨询保密义务的来源,提出遵循来访者对隐私的自我决定和“权益位阶理论”下保密豁免的正当性。明确心理咨询人员在涉及公共安全等利益时负有配合调查义务,面临自然人生命健康可能遭受非法侵害时的预警和保护义务以及针对未成年人和成年心智障碍者的强制报告义务,以期促进保障隐私权益和周全更优位利益的平衡。