心理咨询中领悟质量的评定依据——当事人和咨询师的视角

为获得当事人和咨询师对心理咨询中领悟质量的评定依据,采用协商一致的质性研究方法分别对13位当事人和15位咨询师的访谈材料进行分析。结果：当事人的评定依据包括影响力和特性;而咨询师的评定依据包括影响力、特性、类型、产生方式以及当事人对领悟的接纳程度。结论：领悟的影响力和领悟的特性是评定领悟质量的重要依据。     

心理咨询中领悟质量的评定依据——当事人和咨询师的视角

为获得当事人和咨询师对心理咨询中领悟质量的评定依据,采用协商一致的质性研究方法分别对13位当事人和15位咨询师的访谈材料进行分析。结果：当事人的评定依据包括影响力和特性;而咨询师的评定依据包括影响力、特性、类型、产生方式以及当事人对领悟的接纳程度。结论：领悟的影响力和领悟的特性是评定领悟质量的重要依据。     

早期累积家庭风险对青少年内化问题的影响：弹性双重机制

为了解早期累积家庭风险因素对青少年内化问题的影响及其心理机制,采用累积家庭风险问卷、个人成长主动性问卷、领悟社会支持问卷以及青少年内化问题问卷对780名青少年进行调查。结果表明：（1）累积家庭风险对青少年内化问题具有显著的正向预测作用;（2）累积家庭风险因素还通过个人成长主动性和领悟社会支持的中介作用影响青少年内化问题。研究结果有助于揭示累积家庭风险对青少年内化问题的影响机制,对预防以及减少青少年内化问题行为具有一定的启示作用。     

心理咨询中的“领悟”概念辨析

心理咨询理论和对咨询会谈中重要事件的研究都肯定了领悟在咨询中的重要地位。主流理论取向对领悟的理解并不完全一致,在领悟的概念、领悟的内容、领悟的方式上都存在一些差异,但新联结的建立是公认的领悟的实质。对领悟的分类和实证研究中对领悟的操作性定义,有助于更清晰准确地把握领悟的概念。对心理咨询中的领悟还没有一个非常准确的界定,文中尝试性地定义为:当事人在治疗师的辅助下采取各种方式,对自己和自己的世界形成新的觉知,表现为在个人意义系统中建立新的联结。     

上海公众心理健康观的初步调查研究

本研究初步调查了上海公众的心理健康观,发现①上海公众对心理健康的认识总体上与生物心理社会医学模式一致,多数人认识到心理健康的重要性;②公众对心理健康内容及心理异常表现的认识与心理学家的标准近似;③“早期教育和家庭环境”、“生活事件与环境变迁”及“心理冲突”等三项是影响上海公众心理健康的主要因素;④公众对目前心理医生的认可率不高;⑤约三分之二的公众认为自己的心理健康状况良好;⑥提出广泛开展心理健康教育和咨询工作的迫切性。     

当事人眼中的团体辅导效果：基于协商一致的质性研究

目的：本文从当事人的视角,深入研究团体辅导对于团体成员所产生的作用。方法：采用协商一致的质性研究（CQR）方法,对15个来自不同团体的当事人的深度访谈材料进行分析。结果：发现与团体辅导效果相关的域有4个,即团体辅导的过程效果、团体辅导效果获得的过程和体验、团体辅导效果的影响因素,团体辅导的后续效果。结论：当事人眼里团体辅导效果的内容广泛且丰富,团体依恋既是团体辅导效果的内容也是基础性的疗效因子。     

社会支持、心理控制感对地震波及地区大学生心理健康的影响

目的：了解地震波及地区大学生社会支持、心理控制感与其心理健康状况的关系,为对大学生的心理健康干预提供帮助。方法：通过分层随机抽样,采用症状自评量表（SCL-90）、领悟社会支持量表（PSSS）和控制圈量表（SOC）对1287名地震波及地区的大学生进行测试。结果：（1）地震波及地区大学生的心理健康不佳,主要表现在躯体化、人际敏感、焦虑、恐怖和精神病性5个方面。（2）社会支持和心理控制感对心理健康有重要影响,社会支持直接影响心理健康,社会支持水平低的大学生心理健康水平低;心理控制感影响着社会支持水平,心理控制感强的人所获得的社会支持程度更高。结论：社会支持和心理控制感都是影响心理健康水平的两个重要因素,研究这二个因素之间的关系对维护个体的心理健康,探讨心理障碍产生的心理机制具有十分重要的意义。     

当事人的投入:概念、测量与影响因素

当事人的投入是其从心理咨询与治疗中获益的基本前提,它是指当事人为了实现改变的目标,在咨询或治疗过程中主动参与、不懈努力的心理和行为过程。目前对投入的研究主要考察了行为表现,包括出席会谈、会谈中的投入和会谈外的投入三个核心成分,对应有不同的测量方法。与投入有关的因素包括当事人因素、咨询师及互动因素、家庭和社会文化因素、其他客观因素等,其中当事人的认知动机因素对投入有重要影响。未来研究应继续探讨当事人投入的成分、动力性和影响因素,完善其评估方法及增强当事人投入的干预方法,并进一步检验当事人的投入与咨询效果的关系。     

压力知觉对大学生抑郁的影响:有调节的中介模型

本研究采用压力知觉量表、心理韧性量表、领悟社会支持量表和抑郁量表考察压力知觉对大学生抑郁的影响机制,调查了中部地区5所大学746名大一到大四学生。研究显示：（1）心理韧性在压力知觉与大学生抑郁之间起部分中介作用;（2）领悟社会支持调节了这一中介过程,调节了压力知觉对大学生抑郁的影响及压力知觉对心理韧性的影响。可以通过降低大学生的压力知觉水平、提高心理韧性水平和领悟社会支持水平来减少其抑郁。     

海洛因成瘾者复吸倾向的研究

目的：探讨海洛因成瘾者复吸倾向的影响因素。方法：采用“复吸倾向问卷”对289名戒毒劳教人员进行测评。结果：发现戒毒意愿、将来环境、身心状态、物质替代和社会支持是影响复吸倾向的五个因素。这个结果提示在海洛因成瘾者的康复治疗中应该采用“药物——心理——社会”模式。     

The counselor perspective on the use of directives in counseling in China: Are directives different in China as in the United States?

Eight Chinese counselors were interviewed about their use of directives in counseling. They typically believed that directives can be beneficial in counseling Chinese clients. They used directives to extend the influence of counseling beyond sessions, meet client needs and expectations, and fit their own personality and orientation. In terms of conditions that need to be met for directives to be helpful, they identified client factors such as readiness, communication styles, past experience, and insight; the counselor factor of ability to communicate directives; and the therapeutic relationship. They emphasized the importance of clients acquiring a new perspective as a result of directives. Cultural factors in using directives are discussed.     

Qualitative meta-analysis of insight events in psychotherapy

Purpose: This study reports on a qualitative meta-analysis examining the phenomenon of insight into psychotherapy. Method: Studies (n?=?7, covering 15 insight events of 15 clients) were selected that examined significant events in psychotherapy leading to insight using session recordings and Interpersonal Process Recall interviews with clients and therapists. A conceptual organization of the data using a matrix grid consisting of three domains according to data origin (client process, therapist process, and their interaction) and three domains according to events’ sequence (context, event and key intervention, and impact) was established. Results: Key processes were identified that lead to insight events in psychotherapy. Two distinct types of events according to their main impacts as reported by the clients were identified: Painful/Poignant Insight where clients realized something that was painful, often evoking feelings of sadness or undifferentiated upset containing sadness and hurt; and Self-Asserting/Empowering Insight that led to an impact characterized by a sense of self-assertion and empowerment on the client’s part. A reasonably good alliance and vulnerability on the client’s part represent the context for insight events as does the client’s quest for self-understanding. The therapists’ key interventions in the event leading to poignant/painful insight contain either empathic reflection or collaborative interpretation. In empowerment/self-assertive insight events the therapists offer supportive, validating reframing promoting positive experience. In both types of events the therapist and the client work on consolidating insight. In some events, therapists emphasized cognitive or problem solution focused impacts, while clients emphasized emotional impacts. Some events contained emotional avoidance on the part of the client or therapist thus not realizing the full potential of the event.     

当事人的投入与会谈效果、咨询效果的关系研究

本研究探索了当事人会谈时的投入与即时会谈效果的关系;当事人咨询初期的投入与整体咨询效果的关系。结果发现当事人会谈时的投入与即时会谈效果、在咨询初期的投入与整体咨询效果都呈现显著的正相关。进一步回归分析发现,当事人在咨询初期的投入与整体咨询效果呈现正U型的偏态分布,少数投入水平最低的当事人获得中等水平的咨询效果,中等投入水平的当事人咨询效果最差,投入水平最高的当事人的咨询效果最好。     

Questioning Our Questions: A Constructivist Technique for Clinical Supervision

Consistent themes in the constructivist supervision of counseling and psychotherapy include the fostering of supervisee reflexivity, perspective taking, and capacity to generate alternative conceptualizations and interventions. In keeping with these objectives, we describe a technique for deepening therapists' reflection on their interchanges with clients through “questioning their questions” and the clients' responses to them. We further illustrate the procedure in the supervision of a therapist in training who (a) analyzed in writing a series of six question-and-answer cycles pertaining to a client, (b) considered the larger implications of the interaction for the therapeutic relationship with this client, (c) received supervisory feedback on his journaling, and (d) offered a final reflexive comment on the procedure. We conclude with a few thoughts about variations on the technique to enhance its relevance in different supervisory settings.     

心理治疗中的脱落

脱落是指在心理咨询与治疗中, 来访者由于种种原因在导致他前来寻求帮助的心理困扰或问题尚未解决之前就终止治疗的现象。研究者对脱落概念内涵的理解比较一致, 但脱落的操作性定义存在多种且各有利弊。脱落在临床治疗中普遍存在; 脱落率在跨研究间的结果差异很大, 并受到脱落的操作性定义和研究设计类型的重要影响。传统的静态的变量在预测脱落时存在明显局限, 治疗同盟等治疗过程预测变量近年来得到更多重视, 并丰富了我们对来访者脱落的深入理解。为减少脱落, 研究者建议为来访者提供治疗前准备, 对治疗过程中的关键变量进行评估并根据具体情况采用合适的干预策略。未来研究需要完善脱落的操作性定义, 更多地在自然治疗设置下进行研究, 进一步深化脱落的预测变量研究, 并关注治疗外重要事件及文化背景对脱落的影响。     

Hope as empowerment model: A client-based perspective on the process of hope development

Abstract

Research on the relationship of client hope to successful therapy outcome underlines the need to discover the processes and conditions when hope flourishes. Snyder’s Hope Theory has been applied to psychotherapy but client subjective experiences are needed to illuminate nuances in the process. The present study examined the trajectory of hope development in psychotherapy using interviews with 18 counseling clients, analyzed using grounded theory methodology. Findings were synthesized into a dynamic model titled hope as empowerment model (HEM) that shares features of Snyder’s Hope Theory. HEM introduces patterns of particular salience to psychotherapy. The compatibility of client preferences with therapist input raised faith in the process of counseling and, in turn, hope in a positive outcome. A number of conditions, including the flexibility of client role preferences and the directiveness of hope-inspiring therapeutic strategies, influenced the nature and strength of client hope. Implications for therapy and positive psychology are considered.     

The Client's Perspective of Genetic Counseling—A Grounded Theory Study

Previous studies of genetic counseling have mainly focused on outcomes defined by researchers or service providers, and have frequently related to changes in reproductive behavior and/or client knowledge. A longitudinal study of 43 families referred to a clinical genetic service was undertaken to ascertain client needs and expectations of the service, and to identify relevant outcomes from the clients' perspective. Semistructured interviews were conducted with each client, prior to and after genetic counseling. The transcribed interviews were analyzed using grounded theory. The need for certainty emerged as a powerful factor that motivated clients to pursue the genetic referral. The client's lay knowledge of the condition, satisfaction of the need for certainty, and the formation of a personalized relationship between the client and the genetics staff significantly influenced the central outcome, identified as a change in the client's psychological adaptation to the genetic condition in the family.     

Mental Imagery in Career Counseling and Life Planning: A Review of Research and Intervention Methods

The use of imagery in career counseling and life planning continues to increase just as the use of imagery in counseling and psychotherapy increases. The rationale for using imagery in career counseling and life planning is the same as in counseling and psychotherapy: It allows the client and counselor to bring into awareness unconscious material that is already influencing choices and makes this material usable in future planning. Imagey also allows the client to try on alternative roles. Several studies are cited that indicate that the imagery components of daydreams and fantasies are useful tools for career exploration and life planning when they are accessible to clients and properly processed. Relevant counseling applications and research studies are cited. Some recent tools for eliciting and processing these daydreams and fantasies are presented, and limits as well as benefits of techniques are discussed.