Sex-related patient and therapist effects on clinical judgment

The purpose of this investigation was to submit the claim of sex-related bias in clinical judgment to more thorough empirical testing than had been the case in previous research. Patient sex and stereotypic sex-role were factorially varied in a clinical protocol that was sent with related materials to 640 sex-stratified, randomly selected Members and Fellows of APA Division 29 (Psychotherapy). Approximately 30% (N=182) of those contacted returned usable data, including information about their own sex-role traditionalism and evaluation of the hypothetical patients' psychological well-being. Results confirmed the effectiveness of the stereotypic sex-role manipulation. However, no consistent effects were found for any of the four variables of interest considered in isolation or in combination, thereby refuting allegations of covert sex-related discrimination perpetrated under the aegis of psychological appraisal. Favorableness of clinical impressions was not mediated by therapists' self-reported attitudes toward the patients. The study's generally unexpected outcome was tentatively attributed to enhanced professional sensitization to the sociocultural barriers to full psychological functioning in women.This report is based on a master's thesis written by the first author under the sponsorship of the second and submitted in partial fulfillment of the requirements for the MA degree at Vanderbilt University, 1974. The research was supported in part by the Vanderbilt University Research Council. The contributions of Stephen Amira and Joseph M. Schwartz are gratefully acknowledged.     

The preoedipal patient and the pregnancy of the therapist

This article is a contribution to the sparse literature on the pregnancy of the therapist. The therapist's pregnancy is viewed as an event that can facilitate progress for some female patients with preoedipal problems. In these cases, it provides a dramatic opportunity to address developmental difficulties, including separation problems and inadequate ego ideal formation, through the analysis of the self-object transference. Clinical material illustrates the working through of these issues for a patient in whom the therapist's pregnancy was stressful but not traumatic. Therapeutic interventions were aimed at fostering greater differentiation between self and object. A contrasting case is also examined in which the pregnancy was felt to be traumatic and feelings about it largely denied. However, underlying transference issues were eventually addressed.     

Psychotherapy for lesbians: The influence of therapist sexuality

This study explored the influence of therapist sexuality upon lesbian experiences of therapy, and particularly the influence of marginal and dominant discourses within the process. It is argued that explorations of discourses of sexuality should be a necessary feature of a psychotherapist's training. A postmodern feminist methodology — Bungay and Keddy's adaptation of Reinharz's experiential analysis — was used in the study. This method involved triangulation of interview, literature analysis and reflective diary methods, with analysis drawing upon a discourse analytic perspective. Two sites of contradiction were explored, indicating the possible emergence of resistant lesbian discourses against the dominant patriarchal, heterosexist and homophobic discourses. The study illustrates the discursive and contextual nature of psychotherapy with lesbians.     

Experiences in problem-case seminars on the significance of the relation between therapist and patient for the treatment course

Experience gained during many years of problem-case discussions shows that disruptions in the relationship between patient and therapeutist are often the essential cause of difficulties encountered during treatment. A few characteristic relational difficulties are described: uncertainty of the therapeutist, absence of identification or detachment, and interference of the emotional needs of the therapeutist with the treatment. The contribution points out that the clarification of such disruption often has a beneficial effect on further treatment.     

Ethnic matching between therapist and patient in psychotherapy: an overview of findings, together with methodological and conceptual issues

This article reviews the empirical support for ethnic matching between therapist and patient in psychotherapy. The research has 3 sources: analog studies, archival studies of number of attended sessions and dropout rates, and process-outcome studies of psychotherapy. Clinical trials studying ethnic matching are absent. Empirical support for ethnic matching suffers from low validity and is inconclusive, with few studies of actual psychotherapy. The research is hampered by poor conceptualization of key concepts, difficulties in forming ethnically homogeneous groups for comparisons, and an abundance of uncontrolled within-group variables. Therapist variables, for example cultural sensitivity, are rarely investigated. There is a need for large-scale psychotherapy studies with well-defined key concepts in which the impacts of within-group and therapist variables are investigated.     

A linear relation between loudness and decibels

A total of 37 uninitiated observers made repeated numerical magnitude judgments of the loudness of a sequence of octave band noises spaced at 1-dB intervals, from 0 to 5 dB above a standard of about 80 dB(A), which was called 10. The observers were not instructed to use numbers as ratios. When the median responses are plotted linearly against decibels, they are fitted by straight lines. Each extra decibel adds an average of 1 unit of loudness, range for individual observers 10 through .25 units. This is consistent with the view that the subjectively equal stimulus spacing for the loudness of noise is linear in decibels, and that the observers use numbers linearly in judging the loudness.     

The influence of therapist experience upon evaluative perceptions of family members

Abstract

This study investigated the influence of experience in family therapy on therapists' evaluative perceptions of family members. Beginning students in family therapy, advanced students, and experienced staff rated members of 100 families according to the Semantic Differential technique. Contrary to expectations, beginning students did not evaluate identified patients more favorably than parents. Staff and advanced students, however, rated parents more favorably than identified patients. Beginning students were also found to evaluate all family members more favorably than staff and advanced students. These results were discussed in terms of experienced therapists initially taking the side of the parents and the effects this potential source of bias may have on the course of family therapy.     

The influence of therapist attention on self-injury during a tangible condition

This study investigated the effects of therapist attention on the self-injurious behavior (SIB) of a 6-year-old girl with developmental disabilities. After results of a functional analysis indicated that SIB was maintained by attention and tangible reinforcement, tangible conditions with and without contingent verbal attention were compared. Results suggested that the inclusion of verbal attention in a tangible condition may confound functional analysis outcomes for behavior that is maintained by attention.     

Relationship between therapist empathy and client-perceived working alliance in China: A multilevel modelling analysis

This naturalistic study examined the relationship between two types of therapist empathy, intellectual empathy and empathic emotion, and client-perceived working alliance (WA) in China. The study adopted the definitions and assessment methods of empathy recommended by Duan and Hill and used the theory of WA by Bordin and WA Inventory-Short by Tracey and Kokotovic. Eighty-six clients and 43 therapists from a university counselling centre at a comprehensive university in China participated in the study. Therapist intellectual empathy and empathic emotion and client-reported WA measured in six consecutive sessions from the second through the seventh session were assessed for each session. The results of multilevel modelling analyses showed that client-perceived WA increased significantly session after session, and therapist empathic emotion significantly predicted Tasks of WA. Moreover, there was significant therapist effect associated with Bond. In the context of empathy and WA research findings reported in the USA, some of the non-significant results of this study were intriguing. We discuss the study results with particular attention to the Chinese cultural context and present suggestions for future research.     

Family therapy and outcome: Relationships between therapist and family styles

This study examined therapeutic outcome for a group of 175 clinic families divided into levels of family competence and style, and, later, into seven clinical groupings. The division into these groups was based on the level of rated Competence and Style determined by using the Beavers Systems Model. Therapists also rated their level of Openness/Sharing Strategy, Power Differential, and Partnership with the family at the third session. Results indicate that more competent families who fared well in therapy had therapists who formed a partnership, disclosed strategy, and employed a minimal power differential with the family. The most disturbed families, and those with a Centrifugal style, did better with therapists employing a high power differential and lower levels of openness and partnership. The study also presented the distribution of individual diagnoses by family groups. Implications for family therapists, including the value of family assessment, are provided.     

The influence of individual attachment styles on group members' experience of therapist transitions

Attachment theory has recently been applied to clinical practice in an effort to improve understanding and treatment of the maladaptive relational patterns clients bring to therapy. While most of this research has focused on individual therapy, interest in the application of attachment theory to group psychotherapy is growing. This paper will explore the impact of clients' attachment styles on their experiences of co-therapist transition in an ongoing psychodynamic therapy group. This discussion will elucidate how knowledge of attachment theory and an understanding of clients' individual attachment styles can be useful in predicting responses to therapist-initiated terminations and transitions.