A Family Therapist for Life: Observations and Options

“Life” is used here in the chronological sense of years spent as a family therapist and in the existential sense of experiencing “life” in terms of satisfaction, meaning, and vitality in one’s living. In the 1950s, there were few guidelines for professionals recognizing the need for working therapeutically with families. Becoming and being a family therapist are discussed, along with lifetime learning about family and tolerance for ambiguity in understanding family and marital relationships and dynamics; flexibility in implementing therapeutic interventions; functioning in ways that fit with one’s personality, beliefs, and principles; working where one functions best; and what works at what stage for the family therapist and relating these to establishing and maintaining “life” in one’s living.     

Restoring Dyadic Connection in the Face of Multiple Disruptions: Accounting for Vicissitudes in the Therapist’s Capacity for Reflective Functioning

This article describes the working method of our study group comprised of former Chestnut Lodge Hospital therapists and focusing on understanding therapeutic work with severely disturbed adolescents. Using process material from one therapy session, the therapist’s commentary on her feelings and reactions in the session, and the group’s discussion of the work, we explore factors disrupting the therapist’s moment-to-moment capacity to maintain a theory of her own and the patient’s minds. We then discuss what allows her to refind her theory of mind in the face of the patient’s aggressive nihilism and her own sense of loss. Salutary factors included the therapist’s empathy for the patient’s shared sense of grief, the patient’s offering the therapist cues to his inner state, and the dyad’s capacity to tolerate the therapist’s vulnerability in the patient’s presence.     

The Role of Organizational Leaders in Sexual Orientation Equality at Organizational and Federal Levels

Purpose

This article expands the discourse of the impact of the passage of the Civil Rights Act (CRA) of 1964 to sexual orientation minorities (SOM).

Design/Methodology/Approach

We first discuss the challenges faced by SOM in the workplace. We then present a model adapted from Edelman’s “Handbook of employment discrimination research (pp. 337–352). Dordrecht, The Netherlands: Springer (2005)” theory of endogeneity of law to discuss the impact that such leaders and their supportive organizational SOM policies can have on the passage of nationwide SOM legislation. Finally, we discuss how organizational leaders’ beliefs and actions can play a major role in affecting organizational SOM policies.

Findings

We argue that the presence of organizational protective policies can facilitate the passage of federal SOM legislation by establishing and legitimizing social norms. We also highlight how beliefs about religion, morality, controllability, and occupational stereotypes contribute to prejudice and lack of support for SOM-protective organizational policies.

Implications

We discuss the importance that organizational SOM policies have on larger societal legislative issues, and outline how specific individual-level beliefs can impact organizational-level support for SOM.

Originality/Value

We take a novel approach by focusing on what organizational leaders can do to enact SOM policies that may further influence protective laws. We also draw upon neo-institutional theory to show specifically how organizations can affect legislation; a topic often ignored in organizational psychology.     

Inside out,or outside in: meeting with couples

The complex difficulties often faced by couples require a range of models for effective help. Relational intensity is heightened in therapy by the ease with which the therapist can be triangled into the couple's relationship and by the influence of the emotional triggers from their respective internal worlds. This article draws on systemic and psychodynamic models and a transgenerational perspective for gendered stories. Different time frameworks link interpersonal and intrapersonal themes. In this sense, the therapist works ‘inside out’ and ‘outside in’. A framework of behaviours, emotions, feelings, meanings and beliefs is proposed to help link these perspectives. ‘Invisible contracts’ and the sense of there often being an unconscious ‘pact to disappoint’ are described. Clear models are not enough, for it is the intimate encounter between client and therapist that is the bedrock of therapeutic change and growth. There is no short cut to this sense of intimacy in the unique encounter between therapist and each new couple. Brief examples from practice describe how the issues discussed may be addressed in couples work.     

Occupational Therapy's Role with Victims of Domestic Violence

ABSTRACT

Occupational therapists encounter individuals who are victims of domestic violence in many different settings. The role of the occupational therapist with each client depends on that client's specific needs, the treatment setting, and the skills and beliefs of the therapist. This article presents a theoretical argument for why the occupational therapist should choose to be involved in the treatment of domestic violence. The Model of Human Occupation provides a framework for understanding functional issues related to domestic violence. Methods of assessment and treatment are presented using this model. A continuum of levels of involvement including referrals for resources or treatment, direct and indirect treatment and program consultation is offered. Each level is illustrated with case vignettes demonstrating the therapist's role. Issues related to the challenge of working in domestic violence and reasons that women may refuse intervention are also discussed.     

Working with child sexual abuse: a systemic perspective on whether children need to tell their therapist details of the abuse for healing to take place

As clinicians working with children who have been sexually abused we have observed that many children choose not to give the therapist a detailed account of their abuse. ^{1 1}‘Children’ refers to children and adolescents.
Our hypothesis is that whether or not children tell their story to the therapist hinges upon several factors: whether they have been believed by their significant (non‐abusing) carer(s); their developmental stage; the therapeutic context; and whether they feel their therapist is available to hear the distressing details of the abuse. We explore this through two case studies and conclude that while children's ability to use therapy is affected by multiple factors – societal, cultural, personal, life histories and beliefs about the value of therapy – telling their therapist the details of their abusive experiences is not necessarily a part of effective therapy.     

A Logical Foundation for Rational Emotive Behaviour Therapy

Rational emotive behaviour therapy (REBT) depends on the implications A ? B and B ? C where A is an activating event, B is a belief and C is an emotional consequence. We use this idea to present a logical theory for REBT, and show how it can be used to create a computer program that can be used as a therapist’s aid.     

Gender and the Choice of a Science Career: The Impact of Social Support and Possible Selves

This study examined the relationships among perceived social support, beliefs about how one would fare in a science career, and perceptions and choice of a career in science. Participants were 48 men and 33 women from the Midwestern United States who had been identified as gifted in mathematics and science and participated in a high school science enrichment program. They ranged in age from 24 to 28?years old, and the sample was predominantly White (83.3%). Participants completed an online measure approximately 10?years after the program ended examining their sources of support and beliefs about the self as a scientist to see how these variables influence perceptions of a science career and actual career. We expected that the relationship between perceived support from people and current job held would be mediated by participants’ beliefs about their personal life as a scientist in the future. Similarly, we expected that the relationship between a perceived supportive environment and having a science career would be mediated by participants’ beliefs about their career as a scientist in the future. Findings indicated that social support contributed directly to men’s and women’s ability to envision themselves in a future science career, which, in turn, predicted their interest in and motivation for a science career. No significant gender differences were found in the predictors of men’s and women’s perceptions and choice of a science career. Implications for recruitment of students into scientific majors and careers are discussed.     

The role of personal practice in therapist skill development: a model to guide therapists,educators, supervisors and researchers

Prior to 2000, personal practice (PP) for therapists mostly meant personal therapy. Recently a new landscape of PPs has emerged, with meditation-based programs and therapy self-practice/self-reflection (SP/SR) programs playing an increasing role in training and personal/professional development. The challenge now for practitioners and researchers is to refocus on the role of PPs in training and professional development. Are PPs of value - or not? Do they have a role in therapist development? How might PPs enhance therapist skilfulness? Do different PPs act in similar or different ways? Currently, the PP literature lacks a theoretical framework to guide practitioners in their choice of PPs or researchers in their choice of research questions and measures. The purpose of this article is to provide such a framework, the Personal Practice (PP) model. The PP model proposes primary impacts of PPs in four domains: personal development/wellbeing, self-awareness, interpersonal beliefs/attitudes/skills and reflective skills. The model also suggests a secondary impact on therapists’ conceptual/technical skills when therapists use reflection to consider the implications of their PP for their “therapist self”. We offer some suggestions to enhance the quality of future research, and conclude that PPs may play an important and perhaps unique role in therapist training.     

Parents’ Beliefs about High School Students’ Spatial Abilities: Gender Differences and Associations with Parent Encouragement to Pursue a STEM Career and Students’ STEM Career Intentions

In the present study, we investigated whether parents’ beliefs about their high school aged adolescents’ spatial abilities (i.e., spatial visualization, mental manipulation, and navigation abilities) differed based on their child’s gender. We also examined whether these beliefs related to parents’ encouragement of their child to pursue a Science, Technology, Engineering, or Mathematics (STEM) career as well as students’ actual STEM major and career intentions. Data were collected from 117 pairs of U.S. high school students and one of their parents. We found that parents of young men thought their child had higher mental manipulation and navigation abilities than did parents of young women, even after statistically controlling for adolescents’ actual spatial abilities. Parents who perceived that their child had higher mental manipulation ability were more likely to encourage their child to pursue a STEM career, and those students were more likely to report that they intended to pursue a STEM career. These findings suggest that parents’ beliefs about how good their child is at spatial tasks may be based more strongly on gender stereotypes than on their child’s actual spatial abilities. Helping to make parents aware of these beliefs could be a potential lever of intervention to increase women’s participation in STEM careers.

     

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.     

Client self-image,therapist acting,and the establishment of the therapeutic alliance in a training context

This study examined how clients’ self-image and perception of therapist’s behavior are related to the therapeutic alliance, as well as how these variables change in the psychotherapy process in trainee-led psychotherapy. A total of 164 participants (M = 28.9 years) who attended two semesters of treatment at the Psychology Clinic of Umeå University completed the Working Alliance Inventory (WAI) to evaluate their perception of their alliance with the therapist. They also completed two questionnaires based on the Structural Analysis of Social Behavior (SASB) model to give insight into their self-image patterns and to analyze their perceptions of the therapist’s behavior. The results show that a positive self-image and positive perceptions of the therapist’s actions increased significantly over the course of the therapy, with a corresponding decrease in negative patterns. The alliance scores show that the therapeutic alliance gains significance over time and that it is influenced more by the perception of the therapist’s behavior than by the self-image. The self-image becomes relevant after the mid part of therapy, underlining the role of the therapist in co-creating the treatment relationship. The implications of these results are discussed, and so are directions for future research in other trainee-led settings and samples.     

Women’s preference of therapist based on sex of therapist and presenting problem: An analog study

An analog study was conducted to examine differences in women’s preference for and anticipated comfort self-disclosing to hypothetical therapists of different sexes based on the type of hypothetical presenting problem. The impact of general level of self-disclosure was also examined. Participants included female college students (n?=?187). Anticipated comfort self-disclosing to male or female therapist was rated by subjects when presented with therapists of each sex with the same qualifications. Women preferred and reported higher levels of anticipated comfort self-disclosing to a female therapist. The type of hypothetical presenting problem and general level of self-disclosure also impacted anticipated comfort self-disclosing. There was an interaction between general level self-disclosure and the sex of therapist on anticipated comfort self-disclosing. General level of self-disclosure only impacted anticipated comfort self-disclosing when the therapist was male. This information is relevant for therapists or organizations that provide psychosocial services to women. Organizations may want to inquire about a client’s preferences about sex of therapist beforehand and, if possible, cater to the client’s preference.     

Die Therapeutenvariable

Background

The objective of this study was to investigate the therapeutic attitude as a self-contained dimension of the therapeutic process.

Patients and methods

The psychotherapists’ beliefs and attitudes in therapeutic matters are measured according to the Therapeutic Attitude Scales (TASC) of the Therapeutic Attitude Questionnaire (ThAt) and were applied to investigate the therapist variable. The investigation concentrated on the therapist’s belief in the curative value of a number of ingredients of psychotherapy, on the therapist’s individual style of conducting psychotherapy and on basic assumptions about the nature of psychotherapy and the nature of the human mind. A total of 451 psychotherapists (81 psychodynamic psychotherapists, 208 psychoanalytic psychotherapists and 162 behaviour therapists) were investigated.

Results

There were highly significant differences between the three groups of therapists, a finding which is in line with the basic theory. Adaptation and insight of the assumed curative factors as well as supportiveness and neutrality of the technique factors, differentiate the groups highly significantly. The multivariate analysis underlines the importance of adaptation and insight to differentiate between all groups.

Conclusion

The results by and large confirm the general assumptions held on the differences between the groups. Thus the ThAt appears to be a valid instrument to grasp more subtle features of the therapist variable that may influence the outcome of psychotherapy.     

“Why me?”: Low-Income Women’s Poverty Attributions,Mental Health,and Social Class Perceptions

Although much is known about broad societal attitudes toward poverty, less is known about how women perceive their own poverty. We sought to examine the types of self attributions low-income women make about their poverty, as well as the association of self poverty attributions to women’s mental health and upward mobility beliefs. Using close-ended questions in a community sample of 66 low-income mothers from the Midwestern United States, we found these women were most likely to attribute their poverty to issues related to having children, their romantic relationships, and structural/government blame. The least endorsed attributions for poverty were fatalistic and individualistic reasons. Attributing one’s poverty to children and structural reasons was related to greater depression, and attributing one’s poverty to romantic relationships and structural reasons was related to greater anxiety. Moreover, attributing one’s poverty to children and romantic relationships was positively related to upward mobility beliefs, whereas individualistic attributions were negatively related to upward mobility beliefs. Understanding how women view their poverty and upward mobility can help to improve interventions and policies aimed at low-income women.     

A Pilot Study Implementing Coping Power in Italian Community Hospitals: Effect of Therapist Attachment Style on Outcomes in Children

The study presented the initial report of a project regarding the implementation of the Coping Power Program in Italian community hospitals, and the program’s ability to reduce externalizing behavioral problems in children with a Disruptive Behavior Disorder diagnosis. Usually, interventions for children are implemented by a number of therapists with different personal characteristics, which therefore influence the implementation quality of an intervention. That said, the present study aimed to establish whether the insecure attachment styles of therapists predict unfavorable outcomes for children treated with the Coping Power Program. The sample included 80 children with a Disruptive Behavior Disorder diagnosis and 16 therapists. The results showed that the change in children’s aggressive behavioral problems was significantly related to the levels of the therapist’s preoccupation with relationships. Higher levels of change in aggression (where a higher value means that the aggression at the end of the treatment is higher than aggression at the baseline evaluation) are associated with higher levels of therapist’s preoccupied attachment style (anxious attachment style). This study provided some preliminary evidence that therapists need to be sensitive to their own attachment experiences when delivering therapy for children.     

Predicting People’s Intention to Donate Their Body to Medical Science and Research

Predictors of people’s intention to register with a body bequest program for donating their deceased body to medical science and research were examined using standard theory of planned behavior (TPB) predictors (attitude, subjective norm, perceived behavioral control) and adding moral norm, altruism, and knowledge. Australian students (N = 221) at a university with a recently established body bequest program completed measures of the TPB’s underlying beliefs (behavioral, normative, and control beliefs) and standard and extended TPB predictors, with a sub-sample reporting their registration-related behavior 2 months later. The standard TPB accounted for 43.6%, and the extended predictors an additional 15.1% of variance in intention. The significant predictors were attitude, subjective norm, and moral norm, partially supporting an extended TPB in understanding people’s body donation intentions. Further, important underlying beliefs can inform strategies to target prospective donors.     

Evaluation of self-administered rational emotive therapy programs for interpersonal anxiety

Self-administered rational emotive therapy (RET), withA New Guide to Rational Living (Ellis & Harper, 1975), as the treatment manual, was evaluated by comparing three groups which varied in terms of therapist contact (therapist administered, minimal contact, self-administered). University students who volunteered for the research program involving the treatment of interpersonal anxiety were randomly assigned to one of these treatments or to a wait-list control group. The results for 72 subjects who completed the 5-week program indicated the three treatment groups made significant gains over untreated controls on some of the self-report measures. No between-group differences appeared on ratings by significant others. A four- to five-month follow-up, which obtained data from 41 (58%) of the subjects, provided some support for the maintenance of treatment effects for the therapist administered and minimal contact groups. Correlations of assessed irrational beliefs with outcome measures provided some support for the RET model.Norris D. Vestre, Ph.D., is a Professor in the Department of Psychology, Arizona State University. Terrence J. Judge, M.C., R.N.C., is a nurse therapist at Camelback Vista Treatment Center, Scottsdale, Arizona.     

Is psychoanalysis alive and well at 85? A rejoinder

Psychoanalysis has declined in public interest and scientific validity. It has become a “dead science” and an anachronistic system of beliefs. Its goal of total personality reconstruction is frustrating and futile. Psychoanalytic practice became a form of “exclusive salvationism,” and unconscionable, when it excluded the spouse from participation in the total treatment plan. More frequent interviews over a longer period of time do not produce a therapeutic effect that is “deeper,” and there is no reason to believe that fewer interviews are superficial, or temporary, and that prolongation of an analysis is more likely to produce better therapeutic results. Research studies do not produce any clear-cut winners when psychotherapies are compared. Psychoanalytic theories rest more on argument than on scientific evidence. The patient’s needs seldom, if ever, correspond to the therapist’s theoretical preoccupations, system of beliefs, and indoctrination. Research psychologists, philosophers of science, and eclectic psychiatrists have expressed their dissatisfaction with unproven psychoanalytic doctrines and the concept of “mental energy.” Psychoanalysis is not a pseudoscience, but a “half-science,” whose poetic mythology requires translation into the prose of science.