Multiply Victimized Women: How Do They Change?

Recent studies have demonstrated that women are frequently victims of several types of violent actions via different agents throughout their life spans. Furthermore, multiple victimizations have been associated with psychological difficulties. The present study aimed to understand the change processes, in a self-directed way, of 19 female victims of multiple violent actions during their lifetimes. The women were evaluated for one year using a depression scale and a qualitative interview. The interviews were analyzed using the innovative moments (IMs) model. The results evidenced three groups, according to the evolution of their depressive symptoms during the one-year evaluation period. There were two unchanged groups, one being the symptomatic group (N = 6), which continuously presented symptoms at a clinical level, and the other the asymptomatic group (N = 7), which did not report depressive symptoms at any assessment moment. The change group (N = 6) exhibited a reliable decrease in clinically significant symptoms. Regarding IMs, the majority of the women were able to develop innovative moments regarding the dominant problem over a one-year evaluation period. Those women mobilized alternative ways to address multiple victimization experiences primarily through reflection IMs. Although there were several exceptions to the problematic narratives during the one-year assessment, the change group had a higher proportion and diversity of IM types—namely, a higher reconceptualization and reflection subtype II—compared with the unchanged groups. Moreover, reconceptualization differentiated the change group from the other two groups. These latter IMs may reflect the concept of “postvictimization growth” and the positive changes that arise from experiences of victimization.     

Innovative Moments in Humanistic Therapy I: Process and Outcome of Eminent Psychotherapists Working with Bereaved Clients

This project entailed an intensive qualitative analysis of six-session psychotherapies conducted by three eminent humanistic psychotherapists working with bereaved clients. The Innovative Moments Coding System (IMCS), rooted in narrative therapy, is designed to measure change across therapy orientations. Research using the IMCS suggests that the psychotherapy change process occurs through the emergence, elaboration, and expansion of identifiable change moments for a client—innovative moments (IMs)—which present as exceptions to a client's presenting problematic narrative. There are five identified types of IMs: action, reflection, protest, reconceptualization (RC), and performing change (PC). The current study aimed to inform theory regarding the patterns of IMs across three humanistic approaches—constructivist, person-centered, and existential—when working with bereaved clients, while linking these patterns to observable change in each client's functioning. The alliance between each client and therapist was also assessed across the therapy process, showing consistently strong alliances across the three cases. Findings from the current study reinforce the salience of reflection, RC, and PC IMs in successful grief therapy cases, and also suggest the importance of meaning-making interventions in grief therapy. Clinical implications and suggestions for future research are also addressed.     

Narrative and Clinical Change in Cognitive-Behavior Therapy: A Comparison of Two Recovered Cases

Psychotherapy research suggests that therapeutic change is associated with the emergence and development of innovative moments (IMs)—that is, exceptions to the problematic self-narrative that brought the client to therapy. This study compares two recovered cases of major depression, according to symptom measures, that presented contrasting profiles of evolution of IMs: one typical of successful therapy (Barbara), and another typical of unsuccessful therapy (Claudia). The core conflictual relationship theme (CCRT) was used to study narrative change independently of the innovative moments coding system (IMCS). The results suggest a high congruence between the IMCS and the CCRT profiles. Although Barbara presented changes in the IMCS and the CCRT in a similar way, Claudia's self-narratives (IMs and CCRT), despite symptom change, did not change. The results are discussed, considering the importance of narrative changes in recovery from depression and the maintenance of therapeutic gains.     

Meaning Coconstruction in Group Counseling: The Development of Innovative Moments

This study discusses a model of group counseling, the narrative mediation path (NMP), which is a unique narrative, multimodal approach that combines four narrative modes (metaphoric, iconographic, writing, and bodily) and the narrative group. The purpose of the NMP is to foster reflexive processes with underachieving university students and to improve their academic performance. The study analyzes a single case of group counseling for seven underachieving economics students at an Italian university and the process of meaning construction among NMP narrative modes and the follow-up session. It applies the innovative moments coding system, a reliable method for studying change by tracking narrative innovations in sessions. More specifically, we focus on how innovative moments (IMs: action, reflection, protest, and reconceptualization) evolve during the four different narrative modes and the follow-up session. The findings suggest that the NMP fosters narrative innovations, mainly of a reflexive nature (reflection and reconceptualization). Moreover, during counseling and the follow-up session, the pattern of change is primarily characterized by reconceptualization IMs, the most complex form of narrative innovation.     

Young adults talk about their problems

This study aims to explore how young adults in psychotherapy and young adults in general describe their problems and how their problem formulations change over time. Two matched samples from longitudinal prospective studies were compared using thematic analysis. Semi-structured, in-depth interviews were conducted at baseline, 1.5 years after termination of psychotherapy (N=12) in the clinical sample and 3 years after baseline in the non clinical sample (N=12). Inductive thematic analysis revealed six themes: problems associated with oneself, family, intimate relationships, sense of belonging, occupation, and social roles. The psychotherapy sample was characterized by problems with oneself closely related to other problematic areas, at both pre-treatment and at follow-up 1.5 years after termination, while problematic sense of belonging was a general theme only prior to psychotherapy. However, they were less troubled by their problems after psychotherapy. Problems with oneself decreased considerably in the non-clinical sample, while problems with intimate relationships were twice as frequent at follow-up. In the psychotherapy sample, the initial experience of being passively trapped within their problems was transformed into an experience of being an active agent in their own life. However, considerable differences between the psychotherapy sample and non-clinical sample still persisted at follow-up.     

Innovative Moments in Humanistic Therapy II: Analysis of Change Processes Across the Course of Three Cases of Grief Therapy

The current study is an extension of a complementary investigation examining links between process and outcome within six-session psychotherapies in which three eminent psychotherapists each worked with a bereaved client, using person-centered, existential, and constructivist approaches, respectively. The Innovative Moments Coding System (IMCS) was used in both studies to examine processes of change in the moment-by-moment unfolding of grief therapy. The initial study's findings help inform theory regarding the relevance of humanistic interventions when working with bereaved clients, particularly those that help promote meaning making in the wake of loss. The current investigation extends the original by offering a fine-grained analysis of the progression of innovative moments (IMs) in the context of good-outcome grief therapy, liking specific therapy procedures with positive indicators of client functioning, while providing case illustrations of each therapy dyad. Findings highlight the promise of humanistic approaches in grief therapy, and suggest directions for further research in this area. Implications for future use of the IMCS in psychotherapy process and outcome research are also discussed.     

心理隐喻的变迁与心理治疗模式的转换

心理治疗模式的转换始终伴随着心理隐喻的变迁,每一种心理治疗模式都蕴涵着一个独特的心理隐喻,支撑着研究领域的共同理解。揭示这些治疗模式内蕴的心理隐喻,梳理心理隐喻的变迁轨迹,有助于我们更好地理解心理治疗模式的转换规律,展望心理治疗的发展前景。     

日常经验研究：一种独具特色的研究方法

日常经验研究是一种通过研究日常生活中各种事件发生时人们的瞬时感受而在自发、自然的情景中对人的心理现象、过程进行探索的方法。其目的是通过获得关于个人日常生活中某些特定事件或特定时刻的详细描述,来提取有关思维、情绪、行为的持久性、周期性、变化以及时间结构等方面的信息,并确定上述因素之间的情境性以及倾向性相关。日常经验研究的价值和意义在于在方法论三角互证原则的指导下,与其他各种方法结合起来,帮助研究者从不同角度理解心理现象及其过程,从而达到最大限度地探索、了解人类心理世界的目的     

A Cross-Contextual Construction of Clients' Therapeutic Practice

This study demonstrates how gathering data from a different context can significantly change how an object of study may be viewed. Data from a qualitative diary study of psychotherapeutic practice were used to construct a cross-contextual view of psychotherapy. Data about clients’ everyday lives as well as psychotherapy sessions were analyzed. Examples of how extra-therapeutic factors are significant to client change are presented. Six types of extra-therapeutic information sources that clients use to develop their personal stances while in therapy were identified. The case of one client's abundant use of extra-therapeutic sources of information offers a different construction of how psychotherapy works, emphasizing client activities outside sessions. The implications of the study for psychotherapy research are addressed.     

An empirically-based rationale for a spiritually-integrated psychotherapy

In this paper, we offer an empirically-based rationale, for a particular kind of psychotherapy, spiritually-integrated psychotherapy. Drawing on several lines of research we note that: (1) spirituality can be a part of the solution to psychological problems; (2) spirituality can be a source of problems in and of itself; (3) people want spiritually sensitive help; and (4) spirituality cannot be separated from psychotherapy. We then discuss the defining characteristics of spiritually-integrated psychotherapy. It is based on a theory of spirituality, empirically-oriented, ecumenical, and capable of integration into virtually any form of psychotherapy. The paper concludes by considering potential problems associated with spiritually-integrated psychotherapy, including the risks of trivializing spirituality as simply a tool for mental health, reducing spirituality to presumably more basic motivations and drives, imposing spiritual values on clients, and overstating the importance of spirituality. Perhaps the greatest danger, however, is to neglect the spiritual dimension in psychotherapy. This paper sets the stage for the articles in this special issue of MHRC which describe the development and evaluation of several innovative approaches to spiritually-integrated psychotherapy.     

Parents’ and psychotherapists’ goals prior to psychodynamic child psychotherapy

In order to explore goals of parents and psychotherapists prior to child psychotherapy, the following questions were asked: (1) How are goals for psychotherapy formulated? (2) How can similarities and differences between parents’ and psychotherapists’ goals be understood? Questionnaires regarding psychodynamic child psychotherapies (n = 33) with parallel parental work were analysed using qualitative methodology. The child psychotherapists’ goals were often connected to the intrapsychic and relational development of the child. The parental therapists formulated goals focused on providing support to parents. The parents’ goals, on the other hand, concerned to a great extent giving the child help and to a lesser degree receiving help for themselves. They expressed their expectations concerning the child’s psychological development with a more everyday use of language, often with an emphasis on general psychological wellbeing. The study also indicated that parents had limited knowledge about the therapy’s implementation and framework. Some clinical conclusions could be made. Negotiating goals prior to parental and child psychotherapy can help create realistic expectations and promote a beneficial therapy situation.     

Clients’ Experiences of Disengaged Moments in Psychotherapy: A Grounded Theory Analysis

The study offers an empirically derived model of clients’ experiences of disengaged moments, defined as moments when clients withdraw, distance, or lessen their intensity of involvement with therapy-relevant material or relationships. Interpersonal Process Recall (IPR) interviews were conducted with nine psychotherapy clients of therapists with varied orientations and experience. The interviews were transcribed verbatim and subjected to qualitative analysis using grounded theory analysis (Glaser and Strauss, The discovery of grounded theory: Strategies for qualitative research, 1967) methodology. The results suggested that clients use disengagement for protection from pain, strategic retreat, relationship management, self-through-other discovery, and self-betterment. The core category across all of the experiences of disengagement relates to communicating difficulties and experimenting within the therapy relationship toward self-change. Recommendations are offered for research and practice.     

Innovative Moments as Developmental Change Levels: A Case Study on Meaning Integration in the Treatment of Depression

Innovative moments are alternative meanings to the problems expressed by clients and are organized into three levels. This study analyzes if these levels are not only change markers related to symptomatology outcomes, but also gradual steps in meaning development. A thematic analysis was carried out in a case of depression treated with narrative therapy. Results revealed three themes that evolved from level 1 to level 3. Levels 1 and 2 corresponded to one specific theme and almost all level 3 integrated different themes (polythematic). Level 3 innovative moments might be an integrative bridge allowing the construction of a more adaptive meaning framework.     

Clients' Experiences of Obstructive Silence: Integrating Conscious Reports and Analytic Theories

The psychodynamic literature has associated clients' silences in psychotherapy sessions with a variety of processes. These processes include wishes to merge with the therapist, to gain control in session, to communicate the unsayable, to express helplessness and, most frequently, the intertwined processes of resistance and regression. Experiences of obstructive silence—that is, moments in which clients detached from the process of therapeutic inquiry—were examined in this study. A grounded theory analysis was used to explore clients' experiences of silences in psychotherapy across psychotherapeutic modalities. Two types of obstructive pausing processes, Disengaged pauses and Interactional pauses, were identified. The implications of delineating conscious aspects of these complex experiences are stressed and techniques are suggested for therapeutic intervention in moments of experienced threat.     

Social ties: subgroup differences in costs and benefits

Social ties can be stressful as well as supportive. Are these opposing effects linked, and can they help explain subgroup differences in the efficacy of social support? These questions were applied to data on social support in response to stressful life events. The subjects were 314 women randomly chosen from the registration list of a neighborhood health center in Boston. The data were from the initial interviews of a larger study. The findings include the following: The mobilization of social support was associated with better psychological well-being for women with greater personal resources, but not for those with lower levels of personal resources. Women with lower levels of personal resources were more distressed by life events in the lives of their significant others, especially as the number of these events increased. The subgroup effects of interpersonal support and stress on psychological well-being were independent, separate effects. In sum, women with greater material and psychological resources derived more beneficial support and suffered less stress from their social ties.     

A pilot exploration of the use of compassionate images in a group of self-critical people

Self-criticism has long been associated with a variety of psychological problems and is often a key focus for intervention in psychotherapy. Recent work has suggested that self-critics have underelaborated and underdeveloped capacities for compassionate self-soothing and warmth. This pilot study developed a diary for monitoring self-attacking and self-soothing thoughts and images. It also explored the personal experiences of a group of volunteer self-critics from the local depression support group who were given training in self-soothing and self-compassion. Although using small numbers, this study suggests the potential value of developing more complex methodologies for studying the capacity for self-compassion, interventions to increase self-compassion (including imagery techniques), and their effects on mental health.     

Psychological attachment,no-self and Chan Buddhist mind therapy

The role of Chan Buddhism for mind therapy is distinguished from psychotherapy by the objectives in diminishing or removing the deluded perceived self and the psychological self of attachments and cravings, which are considered as the more basic origins for psychological suffering and problems. The Buddhist concepts of impermanence, no-self and emptiness are discussed to explain the Buddhist explanation for human suffering. A four-stage theory is described to explain the common Buddhist meditation experience toward the realization of no-self. Removing psychological attachment is found to be of explanatory value for many enlightenment episodes of Chan masters. Meditation concentration and reduction of self-attachment will mutually reinforce each other toward a complete therapy of the mind. An innovative approach for psychotherapy in going further to tackle a person's basic life attachments is suggested.     

Special People? An Exploratory Study into Re-entering Missionaries’ Identity and Resilience

Home country re-entry from cross-cultural missionary work abroad may be associated with psychological distress. Re-entrants experience multiple losses including loss of identity which may be associated with personal/relational identity gaps and depersonalization/dehumanization. However, research suggests that some re-entrants are resilient with good mental health, while others are fragile with poor mental health. The aims of this paper are to explore the nature and frequency of re-entering missionaries’ identity gaps and their depersonalization/dehumanization in resilient and fragile re-entrants. Fifteen re-entering adult Australian cross-cultural missionary workers from four interdenominational Australian mission organizations completed semi-structured interviews. Results were analysed using modified Consensual Qualitative Research methods. Links were established between personal/relational identity gaps, depersonalization/dehumanization and resilience on re-entry. Implications for re-entrants’ care are discussed with suggestions for further research.     

Relationship between frequency of involuntary autobiographical memories and cognitive failure

Involuntary autobiographical memories are memories of personal experiences that pop into mind without a conscious attempt at their retrieval. This study investigated individual differences in the number of involuntary autobiographical memories, and explored the relationship between the frequency of occurrence in involuntary autobiographical memory and cognitive failures in everyday memory, as indexed by metamemory questionnaires. A total of 24 undergraduate students reported involuntary autobiographical memories in controlled field interviews, and completed the Everyday Memory Questionnaire and the Cognitive Failures Questionnaire. The results showed that, despite controlled conditions, considerable individual differences were observed in the number of involuntary autobiographical memories reported while walking along a prescribed route on the campus, and that reported memories were predominantly serving self function. In addition, the number of involuntary autobiographical memories was positively related to cognitive failures in everyday memory: participants who acknowledged more problems in everyday memory had a higher frequency of involuntary memories. The implications of these results are discussed in terms of the complementary function of involuntary autobiographical memory in everyday life.