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.     

A call for dialogue: psychotherapists and psychologists specialising in psychotherapy

The development of psychotherapy as an independent discipline in many countries in Europe has stimulated debate within the field of psychology as to what constitutes psychotherapy as a specialism of psychology. The authors, both clinical psychologists who pursued further training in psychotherapy, offer a reflection in this paper on the historical battle between psychiatry and psychology for ‘ownership’ of psychotherapy, describe recent developments in Europe to clarify this specialism within psychology and discuss the distinctive contributions that psychologists offer in developing psychotherapy as a specialism within the discipline. The aim of the paper is to begin a dialogue both within the profession of psychology and outside the profession, with our psychotherapy colleagues, that can develop into an interdisciplinary discourse and a more mutually respectful professional environment.     

The lived experience of psychotherapists working with older clients: an heuristic study

This paper presents the results of an heuristic study based on the research question: ‘How do psychotherapists experience working with older clients?’ The question came from the researchers’ experience and interest in working with older clients in general practice. It started from the researchers’ desire to examine more closely feelings and elements present in their own experience in dialogue with seven other practising therapists who had an interest and experience of working with this client group. Qualities and elements identified were: perceptions of old age and ageism; boundaries and settings; changes to practice; culture and experiences; awareness of time; loss; decline and mortality; and parents and children. These are illustrated by material from each of the participants, a composite depiction of the experience, a creative synthesis and examples from the researchers’ experiences.     

Profiles and professional perspectives: Ten leading former soviet union sport psychologists

Abstract

The primary purpose of this study was to identify 10 leading former Soviet Union sport psychologists and describe their major contributions. The investigators also desired to determine the status and future directions of sport psychology in Russia and the other new countries that formerly comprised the Soviet Union. Balloting for the leading sport psychologists occurred at the newly formed meeting of the Interstates Association of Sport Psychologists (IASP) and 10 persons were identified: Anatoli V. Alekseev, Marina V. Ennolaeva, Leonid D. Gissen. Gennadij D. Gorbunov, Nickolai A. Hudadov. Piotr A. Jorov. Juri A. Kolomeitzev, Albert V. Rodionov, Vladimir R. Sopov, and Bronislav A. Viatkin. These individuals were subsequently interviewed and the results indicated that although many cutbacks have occurred during the previous decade (1980–1990). sport psychologists continue their work. They are developing new and innovative ways to help athletes improve their individual and collective performance. Their work in psychodiagnostics is exemplary. Nevertheless, the future of sport psychology remains uncertain in the Former Soviet Union.     

Attitudes of clinical psychologists towards clients with personality disorders

Previous studies have found that a variety of mental health professionals hold negative attitudes towards clients diagnosed with a personality disorder. These negative attitudes may lead to clients receiving a lower quality of service. Specialist training has been found to improve attitudes towards personality disorders but no empirical studies in Australia have examined this among clinical psychologists. In this study, the attitudes of 81 clinical psychologists towards clients with personality disorders were examined. We were specifically interested in investigating the relationship between recency of specialist training and clinician's attitudes as well as the influence of percentage of personality disorder clients on the clinician's caseload. Results demonstrated that both recency of specialist training and percentage of clients seen were associated with more positive attitudes; however, a higher caseload of clients with personality disorders was the most important predictor of positive attitudes. The implication is that recent participation in specialist training for personality disorders appears to be valuable in improving clinician's attitudes but that more positive attitudes are associated with seeing a greater number of individuals with personality disorders.     

Clinical relationships with forensic clients: A three-dimensional model

This paper considers the clinical relationship with clients in mandatory treatment. In several countries, clients found guilty of committing a sexual or violent offense (often resulting in a jail sentence) are obliged by law to meet a psychotherapist. This mandatory treatment occurs both during the time in jail and in the community. The clinical relationship with these clients is a complex process involving the therapist, the client, and the courts. In this paper we describe some common factors that can facilitate or hinder the therapist's work in this situation.     

Psychologists versus psychologists: evaluating the claims of psychologists who publicly criticize their profession

Since the 1990s, 7 psychologists have written books for a public audience expressing great dissatisfaction with mental health practitioners. These critics represent 4 English-speaking countries: Australia, Canada, the United Kingdom, and the United States. Those psychologists make 3 basic arguments: (a) any improvements attributed to psychotherapy are due to placebo effect, (b) psychological assessments have little value, and (c) clinicians do not meet the legal standards to qualify as experts in a court of law. The present author examines these arguments and concludes that these concerns are unfounded. The exception is that several forensic psychologists had been using tests that were invalid for legal purposes, but this situation has shown gradual improvement in the past 15 years.     

When psychologists work with religious clients: applications of the general principles of ethical conduct

Psychologists become more effective and relevant when they appreciate that many clients hold religious values and commitments. Greater awareness of religion and religious values in the lives of clients may aid clinicians' efforts to provide more accurate assessments and effective treatment plans. The authors use the American Psychological Association's (1992) "Ethical Principles of Psychologists and Code of Conduct" as a framework to examine many of the ethical issues relevant when psychologists work with religious clients. This article also provides suggestions for ways in which clinicians may obtain the skills needed to offer competent assessments and interventions with religiously committed clients.     

Nonerotic dual relationships between therapists and clients: the effects of sex, theoretical orientation, and interpersonal boundaries

We surveyed 223 APA members to investigate the roles of therapists' sex, theoretical orientation, interpersonal boundaries, and clients' sex in predicting therapists' assessments of the ethicality of nonerotic dual relationships with their clients. Results indicated that therapists' sex, interpersonal boundaries, and theoretical orientation influenced ethical judgments of these relationships. Theoretical and practical implications of our findings are discussed.     

Suicide and internalised relationships: A study from the perspective of psychotherapists working with suicidal patients

A study was conducted into the personal meanings of suicide. It is recognised that early experiences of relationships can have a bearing upon a later tendency towards suicide. This project investigated the representations which these relationships take on within the person's inner world and their effect upon the person's behaviour. One hundred psychotherapists were surveyed, by means of a postal questionnaire, regarding their work with suicidal patients. Five follow-up interviews were conducted. The main themes that emerged in the patients' relationships were rejection, invasion and engulfment. These were experienced as forms of abandonment. Incidents involving loss or rejection in the patients' present life were found to re-activate these earlier relationships.     

Addressing multiple relationships between clients and therapists in lesbian, gay, bisexual, transgender communities

Therapists working in lesbian, gay, bisexual, and transgender (LGBT) communities are likely to experience the potential to engage in multiple relationships with their clients. Currently, the American Psychological Association's (2002) ethics code and the related literature base offer minimal direct guidance to therapists practicing in LGBT communities. In this article, the authors review current literature regarding multiple relationships in psychotherapy, considering how this literature addresses issues specific to practitioners working within LGBT communities, present a case study highlighting the negotiation of a multiple relationship between a client and therapist who both identify as lesbian, and offer recommendations for practitioners working within LGBT communities.     

Preventive intervention strategies with hard-to-reach mothers: A collaboration between midwives and psychotherapists

Maternal refusal of psychiatric services can pose a problem for both the family and mental health practitioners. With a sample of mothers who had refused psychiatric services in the past, the present study examined the effectiveness of initiating and maintaining mental health services when midwives acted as mediators. After the midwives had developed a relationship with the mothers, suggestions for mental health services were made again. For part of the sample, therapists accompanied the midwife on a home visit and scheduled subsequent therapy sessions in the home. For the remaining subjects, referrals were made to the local community mental health center. Results indicated substantially greater success in both the initiation and maintenance of therapy when midwives acted as mediators and therapy continued in the home.     

Counseling psychologists and correctional settings: Opportunities between profession and setting

Counseling psychologists are working in correctional settings; yet, research on how the profession and setting interact to achieve successful solutions for corrections is lacking. This paper provides a conceptual starting point for such research by describing three core themes of counseling psychology: strengths-based approaches, person and environment interaction, and developmental approach across the lifespan. Each core theme is applied to various correctional setting needs (e.g. multiculturalism, violence prevention and rehabilitative treatments, developmentally appropriate vocational services across the lifespan) illustrate the unique fit and ability of counseling psychology to produce successful solutions within this non-traditional counseling setting. Describing the solutions generated by the profession of counseling psychology in the correctional setting may encourage more counseling psychologists to consider applying their knowledge skills and abilities to this important and diverse area of public service and professional work.