Psychotherapy, classism, and the poor: conspicuous by their absence

Four decades of research have delineated the need for improved psychotherapeutic opportunities for poor clients, yet psychotherapists remain contradictory in their stance regarding service to the poor. Despite periodic calls within the field to address the needs of poor people, evidence from the psychotherapeutic literature suggests that the poor are still largely absent from consideration. What barriers prevent psychotherapists from enacting their professional principles more consistently on behalf of poor clients? The author suggests that unexamined classist assumptions constitute a significant obstacle for practitioners and presents the experience of confronting her own classism to illustrate the operation of these attitudinal barriers.     

Therapeutic tasks: what kind of help is sought in psychotherapeutic sessions?

One of the main conditions for a good psychotherapeutic alliance is the agreement on therapeutic tasks and goals. This article explores the kind of help that clients expect from therapeutic sessions. By means of a written questionnaire, the clients of a private psychotherapy center, prior to the sessions, expressed their priorities regarding the work to be carried out in them. The assessment of 873 questionnaires showed that clients prefer to participate in therapeutic work that helps them plan actions, understand what is happening, and assess possibilities for change. Also important are therapeutic tasks that help clients evaluate their own actions, both past and planned. The importance that clients attach to different kinds of help varies above all according to how near they feel to resolving their problems. Nine different kinds of psychotherapeutic tasks are identified, which cover the possible requests a client can make of his/her therapist. This article discusses the clinical application of this model as a basis for planning and classifying psychotherapeutic interventions.     

The Future of Psychotherapy and the Expanding Universe or Michael J. Mahoney

Human Change Processes (Mahoney, 1991) is an attempt to set experiential psychotherapy on a scientific basis. The first tow-thirds of the book, based on an extensive survey of diverse scientific and scholarly literatures, argues fairly convincingly for a conception of human beings in which attachment, subjectivity, emergent and unconscious mental processes-especially regarding the self-and emotionality are central to human development and psychotherapeutic change. The book's last part, a discussion of experiential psychotherapy, based largely on clinical experience and intuition, is vague on important points of psychotherapeutic procedure ad process and is less convincing. The disjunction between the scientific discussion of psychology and the non-scientific discussion of psychotherapy is the book's major flaw. Nevertheless, the book is important as an attempt to synthesize a psychotherapy that is at once humanistic and scientifically informed.     

Le geste suicidaire et la faute inexcusable de l’employeur

When a suicidal act is attributed to work, in addition to the qualification of a work accident, the employer's inexcusable fault, based on his obligation of safety, can be retained if the latter was aware of the danger incurred by his subordinate and did not take the necessary measures to protect him. Two points stand out. On the one hand, the risk of suicide is not always predictable, which leads to a more general thinking on its prevention. On the other hand, since 2015, two conceptions regarding the obligation of security have coexisted, new in labour law and, constant in social security law, with litigation falling under two separate chambers of the High Court. Three judgments from October 8, issued by the second civil chamber of the High Court appear to be moving towards a harmonization of case law. Consequently, their scope should be assessed, in particular regarding the preventive measures expected from the employer.     

Group psychotherapy process in the treatment of hostages taken in prison

Group psychotherapeutic techniques with former correctional hostages are discussed. Recommendations are offered regarding the management of such individuals with regard to returning to work, administrative management, hostages' families and the inevitable court appearances. A brief overview of hostage symptom psychodynamics is offered.     

Ethical Considerations for Therapists Working With Demographically Similar Clients

The increasing emphasis on multicultural competence within psychotherapy continues to highlight the need for being sensitive to key differences between therapist and client. However, this attunement to the psychotherapeutic impact of therapist–client differences may obscure the equally critical need to evaluate ethical problems associated with therapist–client similarities. It will be argued that therapists treating clients who are demographically similar to themselves encounter a unique set of ethical challenges that warrant careful consideration and caution precisely because of therapist–client matching. The extant research on matching therapists and clients based on demographic similarities is discussed, with a particular emphasis on psychotherapeutic outcomes and client preferences. Attention then turns to the nonrational heuristics and biases that can often cloud therapists’ ethical decision making regarding the appropriate uses versus contraindications for demographically matching therapists and clients. Within the discussion of nonrational heuristics and biases, suggestions are offered for managing related challenges for ethical decision making.     

Speak No Evil: Scientists,Responsibility, and the Public Understanding of Science

In this paper, I will discuss the responsibilities that scientists have for ensuring their work is interpreted correctly. I will argue that there are three good reasons for scientists to work to ensure the appropriate communication of their findings. First, I will argue that scientists have a general obligation to ensure scientific research is communicated properly based on the vulnerability of others to the misrepresentation of their work. Second, I will argue that scientists have a special obligation to do so because of the power we as a society invest in them as specialists and professionals. Finally, I will argue that scientists ought to ensure their work is interpreted correctly based on prudential, self-interested considerations. I will conclude by offering suggestions regarding policy considerations.     

On the Fulfillment of Moral Obligation

This paper considers three general views about the nature of moral obligation and three particular answers (with which these views are typically associated) concerning the following question: if on Monday you lend me a book that I promise to return to you by Friday, what precisely is my obligation to you and what constitutes its fulfillment? The example is borrowed from W.D. Ross, who in The Right and the Good proposed what he called the Objective View of obligation, from which he inferred what is here called the First Answer to the question. In Foundations of Ethics Ross repudiated the Objective View in favor of the Subjective View, from which he inferred a Second Answer. In this paper each of the Objective and Subjective Views and the First and Second Answers are rejected in favor of the Prospective View and a Third Answer. The implications of the Prospective View for another question closely related to the original question are then investigated: what precisely is your right regarding my returning the book and what constitutes its satisfaction?     

Professionalisierung der Supervision

Supervision is a central domain of professional education and clinical practice. Supervisors features for qualification as well as formal training standards have been largely neglected. In this article the proposals of different psychotherapeutic societies concerning the features for qualification are discussed. Additionally, some training concepts are presented. Suggestions for future development in this area are addressed including the need to refine further operationalized competence, develop conditions for accreditation and certification regarding supervision competencies.     

Perceptions of Clients and Counseling Professionals Regarding Spirituality in Counseling

Although current research indicates that psychotherapeutic change both affects and is affected by spiritual concerns, relatively little is known about the degree to which spirituality is used as an intervention in counseling and how it is perceived by clients and mental health professionals. The purpose of this study was to examine the perceptions of clients and professionals regarding the use of spirituality in counseling. The results suggest that more professionals may be using spirituality in counseling than has previously been reported.     

Crow Indian justice: Strategies of informal social control

This study presents ethnographic findings based on fieldwork conducted on the Crow Indian Reservation in Southeast Montana. Special focus is placed on patterns of informal social control which help preserve a condition of communal harmony among reservation Indians. Aspects of kinship obligation, religion, ceremony, and personality are introduced as strategies influencing early socialization and adherence to rules. Off‐reservation problems of assimilation regarding alcohol abuse and adjustment to non‐Indian judicial systems are discussed.     

Conceptualizing Genetic Counseling as Psychotherapy in the Era of Genomic Medicine

Discussions about genetic contributions to medical illness have become increasingly commonplace. Physicians and other health-care providers in all quarters of medicine, from oncology to psychiatry, routinely field questions about the genetic basis of the medical conditions they treat. Communication about genetic testing and risk also enter into these conversations, as knowledge about genetics is increasingly expected of all medical specialists. Attendant to this evolving medical landscape is some uncertainty regarding the future of the genetic counseling profession, with the potential for both increases and decreases in demand for genetic counselors being possible outcomes. This emerging uncertainty provides the opportunity to explicitly conceptualize the potentially distinct value and contributions of the genetic counselor over and above education about genetics and risk that may be provided by other health professionals. In this paper we suggest conceptualizing genetic counseling as a highly circumscribed form of psychotherapy in which effective communication of genetic information is a central therapeutic goal. While such an approach is by no means new—in 1979 Seymour Kessler explicitly described genetic counseling as a “kind of psychotherapeutic encounter,” an “interaction with a psychotherapeutic potential”—we expand on his view, and provide research evidence in support of our position. We review available evidence from process and outcome studies showing that genetic counseling is a therapeutic encounter that cannot be reduced to one where the counselor performs a simple “conduit for information” function, without losing effectiveness. We then discuss potential barriers that may have impeded greater uptake of a psychotherapeutic model of practice, and close by discussing implications for practice.     

Role of countertransference in complex psychotherapy]

The psychotherapist has a key position in any psychotherapeutic situation, participating in the psychotherapeutic process with all his personality and responding both consciously and unconsciously to the patient and the entire psychotherapeutic system. Countertransference consists of those actions and emotional manifestations on the part of the psychotherapist, which originate from his unconscious strata as a reaction to the overall situation. The existence of countertransference and its possible interference with, and perhaps adverse effect on, the psychotherapeutic process require close scientific and social controls. Also, it will be necessary to make "self-experience" psychotherapy (educational analysis) a required subject. Countertransference also has important perception- and empathy-promoting functions.     

Becoming a person: How long-distance walking can lead to personal growth – A cultural and health-related approach

Long-distance walking is an activity that has been practiced across cultures and ages. More recently, it has been associated with notions of mental health, and it has been suggested that long-distance walking may have psychotherapeutic effects. There is still, however, a lack of clarity regarding several central questions, including what long-distance walking is, and why it may be beneficial to mental health. In this article, we provide an overview of understandings and cultural expressions of the long-distance walk, and we provide a new definition, reaching across these various understandings and expressions. Next, we discuss the different explanations given regarding the therapeutic aspects of the long-distance walk, and suggest a new approach, leaning on an existential framework. Finally, we discuss the implications that the knowledge on long-distance walking has for notions of therapeutic interventions more generally.     

The emerging relationship of psychology and the Internet: proposed guidelines for conducting Internet intervention research

The Internet is rapidly developing into an important medium of communication in modern society, and both psychological research and therapeutic interventions are being increasingly conducted using this new communication medium. As therapeutic interventions using the Internet are becoming more prevalent, it is becoming increasingly important to conduct research on psychotherapeutic Internet interventions to assist in the development of an appropriate standard of practice regarding interventions using this new medium. In this article, we examine the Internet and the current psychological uses which are being initiated using this medium. Ethical concerns related to the psychological use of the Internet are discussed, and guidelines are proposed for the conduct of Internet intervention research.     

Kandidaten in psychotherapeutischer Ausbildung

In the context of the discussion about a reform of psychotherapeutic training in Germany the question arises, which factors influence the decision of psychologists and physicians for a particular training. 343 candidates in psychodynamic, behavioural or psychoanalytic training were asked about their motives for the training, their professional objectives in general and their satisfaction with their choice of training. The candidates' decision for a particular training was associated with personal attitudes and professional goals, with the given information about psychotherapeutic treatment within their studies and with their field of study. For the most part, the respondents are not satisfied with the quality and quantity of information on psychotherapeutic treatment within their studies. Candidates in analytic training are altogether more satisfied with their choice of training and do not plan to start an additional psychotherapeutic training as often as candidates in behavioral training. The consequences of these results in particular for the medical and psychological curricula (a more balanced representation of psychotherapeutic methods) are discussed.     

Prospective Possibilism

There has been considerable debate regarding the relative merits of two theses about moral obligation known as actualism and possibilism. Both theses seek to give expression to the general idea that one ought to do the best one can. According to actualism, one’s obligations turn on what would happen if one chose some course of action, whereas, according to possibilism, they turn on what could happen (i.e., what one could make happen) if one chose some course of action. There are two strands to the debate: the substantive verdicts that the two theses render in particular cases, and the accounts that they yield of the conceptual structure of moral obligation. Possibilism is conceptually appealing, whereas actualism is not, but the latter may seem to render superior substantive verdicts. In this paper, it is argued that, by turning from the objectivist’s emphasis on what is actually best to the prospectivist’s emphasis on what one’s evidence indicates is best, possibilists can provide an account of moral obligation that is both conceptually and substantively attractive.     

Changing the Past,Present, and Future

Abstract

There has recently been a growing movement within psychology toward placing a greater emphasis on the positive aspects of human nature. This movement, known as positive psychology, focuses on the scientific study of human strengths and virtues as well as the variables that promote positive traits, emotions, and institutions. The purpose of this article is to discuss selected topics of research in positive psychology and the potential psychotherapeutic application of this research for children and youth, particularly in school settings. Interventions are presented for altering and enhancing children's and adolescents' perspectives regarding their past, their experience of the present, and their hopes for the future.     

Disclosing Extra-Dyadic Involvement (EDI): Understanding Attitudes, Subjective Norms, and Perceived Behavioral Control

Extra-dyadic involvement (EDI) is a complex issue that affects many individuals, couples, and families. One important, relatively unexplored issue concerns the disclosure of EDI. Despite some scholarly discourse on whether disclosure should be facilitated in a therapeutic context (e.g., Butler et al. in J Marital Fam Ther 35:125–143, 2009; Butler et al. in Am J Fam Ther 36:265–283, 2008), empirical research has not studied the intrapersonal or interpersonal processes related to disclosure. In this study, we explored potential factors involved in the decision to disclose EDI by looking at the relationships among attitudes towards EDI (in terms of perceived justifications and costs), subjective norms (obligation to disclose), and perceived behavioral control (difficulty) associated with EDI disclosure. Our sample included 337 individuals enrolled in at least one university course at one of three geographically distinct universities. Findings indicate that more permissive attitudes towards EDI are not significantly associated to the perceived difficulty in disclosing EDI or the obligation associated with disclosing EDI involving sexual intercourse. However, more permissive attitudes are related to lower felt obligation to disclose EDI that does not involve direct sexual intercourse. Conversely, more restrictive attitudes towards EDI (perceived severity, degree of perceived upset, and how detrimental it is perceived to be to the relationship) predicted greater difficulty but also greater obligation in disclosing all forms of EDI. Specific implications of these findings, including potential implications for therapy, are discussed. Overall, this study provides preliminary information regarding potentially useful factors to consider in understanding the EDI disclosure process that may also be useful in developing intervention points in therapy.     

Integrative Therapie von narzisstisch gestörten Patienten

The psychotherapy of patients with a narcissistic personality disorder continues to be a psychotherapeutic challenge. There is still no psychotherapeutic program for the treatment of these patients which integrates different psychotherapeutic methods and strategies. Therefore the therapy of narcissistic patients remains difficult and only few psychotherapists voluntarily meet the challenge of treating such patients. In this article an integrative psychotherapeutic concept for the treatment of narcissistic patients using psychotherapeutic methods of different psychotherapeutic schools is presented. This integrative concept includes basic strategies such as working with the therapeutic alliance, schema work and activation of resources. On the other hand specific modules for different core symptoms of these patients are proposed. With this article the authors hope to contribute to a new conceptualization of the psychotherapy of narcissistic patients.