A Danish Model for Treating Victims of Rape and Sexual Assault: The Multidisciplinary Public Approach

High prevalence and long-lasting implications of human-inflicted trauma call for effective treatment approaches reaching clients in need of trauma-specific treatment. Numerous approaches exist, but often with limited empirical support. There is also a tendency toward segregating treatment approaches depending on type of exposure history and presenting symptoms. This might exclude clients in need of trauma-specific treatment; therefore, treatment approaches that can reach more heterogeneous groups of clients are needed. In this article, a group-based treatment approach adjusted to include clients with a wide range of trauma-related problems and traumatic experiences will be presented. A brief outline of the approach is presented, together with the theoretical and empirical background, to facilitate implementation by practitioners and empirical testing.     

Managing Emotional Responses in Therapy: An Adapted EFT Supervision Approach

Therapists often encounter experiences in therapy that elicit emotionality, this could be in the form of self-of-the-therapist issues, compassion fatigue, or professional burnout. Whereas approaches to supervision for self-of-the-therapist issues recognize the need for accessing the supervisee’s emotionality, approaches have not focused on how the clinical and professional system could also be part of the cycle. We propose an adapted emotionally focused supervision approach that employs steps one through six of the EFT model. To display how this approach would work, we provide the example of work with longer-term clients. Working with longer-term clients can be a challenge for many therapists, and both the professional and client system come with factors increasing emotional risk to the therapist. Engaging the therapist’s emotionality through supervision has the potential to improve therapeutic outcomes, as well as reduce loss of good therapists in the field to professional burnout.     

A modified cognitive-behavioral approach to group therapy with the elderly

Group approaches to treatment subsume a wide variety of techniques. The present article describes a modified cognitive behavioral approach as developed by the author for certain groups of elderly clients. This modified approach incorporates principles of cognitive behavioral therapy in combination with humanistic, and developmental perspectives, while leaving room for addressing psychodynamic issues if desired. It is suggested that such an approach is of value where structured group techniques are called for.     

Therapist Self-disclosure and Culturally Competent Care with Mexican–American Court Mandated Clients: A Phenomenological Study

Therapist self-disclosure (TSD) is a skill with numerous potential benefits and risks for the therapeutic alliance. While its effects have been established, little empirical research has examined the impact of TSD in cross-cultural treatment settings with court-mandated clients, a context with unique considerations. In an effort to help fill this gap, results of a phenomenological study examining the effects of TSD on Mexican–American men working with Anglo American therapists in a mandated treatment setting are presented. The results of this study indicate that TSD is a culturally competent intervention with several benefits for mandated clients, including strengthening the therapeutic alliance, normalizing client problems, lessening the therapist-client hierarchy, and modeling the acceptability of self-disclosure. Clinical and marriage and family therapy educational implications are also discussed.     

Assessment and Treatment of the Schizotypal Personality Disorder

The Schizotypal Personality Disorder, first appearing as a DSM diagnosis in 1980, is not well understood by social workers and mental health rofessionals in general. Because relatively little has been written a out the disorder, it may be underdiagnosed. Social workers need to be alert to its dynamics, however, as it calls , for a treatment approach different from that of other personality disorders and schizophrenic disorders. Schizotypal clients are rigid and difficult to treat, but when properly identified can be helpful to make a better adjustment to their environments. Long-term, relationship oriented treatment is the intervention most effective with these clients.     

Interventions in everyday lives: How clients use psychotherapy outside their sessions

The purpose of psychotherapy is to help clients address and overcome problems troubling them in their everyday lives. Therapy can therefore only work if clients include it in their ongoing lives to deal with their problems. Detailed, systematic research is needed on how clients do so in their everyday lives outside their sessions. A design of exploratory case studies on this topic is presented in this article. The main outcomes of such a case study on family therapy are then laid out in general terms. They highlight how treatment practices and clients’ ordinary everyday practices interact when clients change their everyday lives to overcome their troubles. They also highlight what it involves for clients to accomplish this. It is concluded that we need more research on how to understand intervention; on the interaction between interventions and clients’ conduct of their everyday life; on sessions as a particular, secluded part of clients’ ongoing everyday lives, and on how to consider therapists’ procedures and conduct of sessions accordingly.     

Getting “SMART” about implementing multi-tiered systems of support to promote school mental health

With the growing adoption and implementation of multi-tiered systems of support (MTSS) in school settings, there is increasing need for rigorous evaluations of adaptive-sequential interventions. That is, MTSS specify universal, selected, and indicated interventions to be delivered at each tier of support, yet few investigations have empirically examined the continuum of supports that are provided to students both within and across tiers. This need is compounded by a variety of prevention approaches that have been developed with distinct theoretical foundations (e.g., Positive Behavioral Interventions and Supports, Social-Emotional Learning) that are available within and across tiers. As evidence-based interventions continue to flourish, school-based practitioners greatly need evaluations regarding optimal treatment sequencing. To this end, we describe adaptive treatment strategies as a natural fit within the MTSS framework. Specifically, sequential multiple assignment randomized trials (SMART) offer a promising empirical approach to rigorously develop and compare adaptive treatment regimens within this framework.     

Teaching Approaches and Occupational Therapy Psychoeducation

Abstract

Patient education has become an important feature of any treatment program. Psychoeducational procedures dominate the treatment used by occupational therapy practitioners in psychiatric rehabilitation. Occupational therapy literature frequently describes the content of psychoeducational programs but rarely examines the teaching approach therapists use in them. It is necessary, therefore, to begin carefully questioning how we are approaching psychoeducation and justifying it as a method compatible with our basic philosophical principles and our growing understanding of occupation. Three approaches to teaching are examined and contrasted with occupational therapy values: the executive approach, the therapist approach, and the liberationist approach. Each of these approaches points to dramatically different outcomes of the therapeutic process. Ultimately, they bring into question the way in which we build a relationship with our clients. The liberationist approach is proposed as the best guide of how and why to use psychoeducation in the quest for providing authentic occupational therapy.     

A dynamic approach to psychological strength development and intervention

Many practitioners working with clients from a strengths perspective largely rely on ad hoc interventions and employ a simplistic ‘identify and use’ approach. In this article, we suggest that clients can extract greater benefits when practitioners adopt more sophisticated approaches to strengths intervention. We introduce an alternative approach that we call ‘strengths development’. This approach is distinguished by the view that strengths are not fixed traits across settings and time (the dominant, contemporary approach to personality). Instead, we adopt dynamic, within-person approaches from personality science to research, assessment, and interventions on strengths. Specifically, strengths are highly contextual phenomena that emerge in distinctive patterns alongside particular goals, interests, values, and situational factors. Strengths are potentials for excellence that can be cultivated through enhanced awareness, accessibility, and effort. Finally, we outline potential psychological risks associated with the strengths perspective that are worthy of explicit discussion with clients.     

Trichotillomania: Identification and Treatment

Trichotillomania is a disorder distinguished by recurrent hair pulling resulting in hair loss ( American Psychiatric Association, 2000 ). This review of the literature provides a broad overview of the disorder so that counselors can better understand, describe, identify, and implement effective treatment for clients with trichotillomania. Phenomenology, impairment, etiology, multicultural considerations, differentiation, comorbidity, and current treatment approaches are presented.     

A solution-focused approach to working with clients who are suicidal

Self-harm and suicide are amongst the most challenging and frightening problems that therapists and counsellors can encounter in the course of their work. The risk of clients harming themselves in the course of treatment can debilitate the therapists from acting creatively and collaboratively, and make their actions defensive, focused solely on risk assessment rather than therapeutic change.Yet it is precisely a creative and collaborative response, such as that engendered by solution-focused therapy and other models, that is the most likely to facilitate change and re-empower clients to take back charge of their lives. This article describes a solution-focused approach to working with suicidal clients that can be used in conjunction with traditional approaches and which focus on establishing safety as well as assessing risk.Working from this model the clinician shifts to identifying client strengths and coping skills, to collaborating with the client to establish meaningful goals and to helping the client envision a positive future. Arguably, such an approach can increase collaboration between therapist and client and lead to a more client-centred safety plan.     

Solution-focused brief therapy: a review of the outcome research

Solution-focused brief therapy (SFBT) is a new and increasingly used therapeutic approach that focuses on helping clients construct solutions rather than solve problems. The approach evolved in a clinical context amid many anecdotal reports of success from both therapists and clients, but it has not been subjected to controlled empirical testing until very recently. In this article we critically review all of the controlled outcome studies of SFBT to date (N = 15) to assess the extent to which SFBT has received empirical support. Five studies were well-controlled and all showed positive outcomes--four found SFBT to be better than no treatment or standard institutional services, and one found SFBT to be comparable to a known intervention: Interpersonal Psychotherapy for Depression (IPT). Findings from the remaining 10 studies, which we consider moderately or poorly controlled, were consistent with a hypothesis of SFBT effectiveness. We conclude that the 15 studies provide preliminary support for the efficacy of SFBT but do not permit a definitive conclusion. Our critique highlights areas where methodology in future studies can be strengthened to provide more conclusive evidence of SFBT efficacy.     

A New Model to Facilitate Individualized Case Conceptualization and Treatment of Social Phobia: An Examination and Reaction to Moscovitch's Model

Moscovitch's (2009) model of social phobia is put forth as an integration and extension of previous cognitive-behavioral models. The author asserts that his approach overcomes a number of shortcomings of previous models and will serve to better guide case conceptualization, treatment planning, and intervention implementation for clients with social phobia. Here I respond to these claims and examine the new and not-so-new aspects of Moscovitch's model. Moscovitch provides creative ways of thinking about feared stimuli and maladaptive methods for anxiety management used by clients with social phobia, and these notions may indeed expand our horizons, linking cognitive-behavioral thought to literatures on emotional suppression and emotion regulation. Other aspects of Moscovitch's thesis do provide heuristic and useful approaches to the assessment and treatment of social phobia which may be of great utility to the cognitive-behavioral clinician, but they do not provide a truly new approach to understanding the psychopathology or treatment of social phobia.     

An Examination of Addiction Treatment Completion by Gender and Ethnicity

The authors examined the discharge status of all clients admitted to an intensive outpatient facility over the course of 1 year, specifically exploring differences based on client gender and ethnicity. The article also argues the need for more culturally sensitive addiction treatment and addresses some alternative approaches.     

Mindfulness,Christian Devotion Meditation,surrender, and worry

This article will present an approach for accommodating the benefits of mindfulness into therapy with Christians struggling with worry. Given the psychological benefits of mindfulness and its connection to spirituality, it is not surprising that both therapists and Christian clients are attempting to incorporate it into counselling. Centering prayer, which is a form of Christian Devotion Meditation, provides an accommodative approach to managing worry for Christian clients. The results of this study indicate that surrender, a key component of centering prayer, provides an empirical link for incorporating the benefits of mindfulness for Christians.     

Cognitive-Behavior Therapy for Compulsive Checking in OCD

There is substantial evidence for the effectiveness of psychological treatments for OCD, and various approaches have been widely recommended. These approaches tend to be characterized by exposure and response prevention (ERP) and also tend to be applied equally to all forms of OCD. Patients/clients (and some therapists) often find ERP to be a difficult treatment, and both dropout and refusal rates are unacceptably high. Based on specific cognitive conceptualizations of different manifestations of OCD, new and refined cognitive treatment methods are now available. The present article describes a specific cognitively based approach to the treatment of compulsive checking.     

Behavior Therapy in a Family Context: Treating Elective Mutism

This paper discusses the necessity of using both behavioral and family approaches in combination, while working with electively mute children. The symptom and its significance within the family system is presented along with a rationale for avoiding the pitfalls of individual approaches with such children. A case history outlining specific behavioral techniques is described in detail with an exploration of the use of reinforcement theory, counter-conditioning, and successive approximations in bringing about change in electively mute children. The need for bringing about changes within the family system so as to maintain the changes that have occurred through use of the behavior techniques is discussed and presented as crucial to the treatment process. The paper takes the position that either approach, by itself, will not be effective in helping electively mute children but that the treatment of choice is a combination of therapeutic techniques.     

Internal cohesion psychotherapy: The nature,principles and application

Psychotherapy is widely used to treat different mental health disorders and emotional difficulties. The main objective of psychotherapy is to help clients become aware of and have control over their thoughts, moods, feelings and behaviours, as well as create healthy strategies to respond to challenging situations. Since the existing psychotherapy approaches and other methods of treatment are not always effective in treating mental health disorders, there is still space for new approaches to fill this gap. In this paper, we provide information about internal cohesion psychotherapy, which is a new integrative approach. This paper presents a new approach to eclectic psychotherapy, focussing on four detrimental aspects of human functioning through different time perspectives.     

A Therapeutic Model of Self‐Forgiveness With Intervention Strategies for Counselors

Self‐forgiveness is associated with psychological and relational well‐being and may be a worthwhile treatment goal for clients who have hurt others. The authors utilized theoretical and empirical literature to describe a 4‐component therapeutic model of self‐forgiveness—responsibility, remorse, restoration, and renewal—and offer suggestions for promoting each component with clients. Finally, the authors explore potential contraindications and the applicability of self‐forgiveness for military veterans, clients in substance abuse treatment, and clients convicted of a crime.