Chapter 7 The Gay Therapist's Response to a Gay Client Practicing Unsafe Sex

Abstract

The significance of psychoanalytic perspectives for brief psychotherapy is discussed in the report of a gay man practicing unsafe sex (known colloquially as “barebacking.”). The paper focuses both on understanding transference and counter-transference issues in work with this man.     

Chapter 1 Pluralism,Pragmatism, and the Therapeutic Endeavor in Brief Dynamic Treatment

Abstract

This article places representative formulations of brief dynamic psychotherapy in the larger context of psychoanalytic thought, reviews relational perspectives that inform contemporary approaches to time-limited treatment, and identifies tasks in continued development of theory, research, and practice. In doing so, it emphasizes the need to consider a broader range of psychopathology, dysfunction, and need in formulations of brief intervention and to develop more flexible and realistic approaches in treatment of vulnerable and underserved populations. The growing emphasis on theoretical pluralism and pragmatism in therapeutic practice generally should facilitate efforts to broaden the base of brief dynamic treatment.     

Ethical Considerations for the Treatment of Youth in Foster Care

Mental health clinicians treating youth in foster care face several ethical challenges, such as competence for treating youth in foster care, understanding who can provide informed consent, and confidentiality. However, few articles have addressed these ethical concerns or provided recommendations for clinicians on how to navigate these issues. This article presents a brief summary of the foster care system, an overview of the major ethical challenges clinicians may encounter when treating youth in foster care, areas of the American Psychological Association’s Ethics Code, Code of Ethics of the National Association of Social Workers, and American Counseling Association Code of Ethics most germane to the treatment of youth in foster care, and general recommendations for clinicians treating this population.     

Mental Health Stereotypes About Gay Men

Three studies were conducted to examine the mental health stereotypes about gay men among college student and therapist trainee samples. Results from Study 1 indicated that (a) college students and therapist trainees endorsed a stereotype of the mental health of gay men that was similar in terms of its content and strength, and (b) the stereotype was consistent with five DSM-IV-TR disorder categories: mood, anxiety, sexual and gender identity, eating, and personality disorders. In Study 2 and 3 we investigated whether homophobia or a tendency to report cultural beliefs could account for the lack of difference between college students and therapist trainees. Results did not support either explanation.     

Chapter 2 Using Self Psychology in Brief Psychotherapy

Abstract

This article seeks to help clinicians make the translation from theory to practice when using self psychology to do brief psychotherapy. After a theoretical overview and review of the literature, a series of organizing questions and frameworks is provided to facilitate the clinician's capacity to apply a self psychological point of view to the understanding and conduct of brief treatment.     

Chapter 5 Development,Psychopathology, and Brief Psychotherapy

Abstract

When using a developmental model to conceptualize curative factors in brief psychotherapy, the impact of the developmental process and the nature of the psychopathology presented by the patient must be taken into account. Both factors shape the therapeutic work. A case example of a young adult in the midst of developmental transition illustrates these issues.     

Treatment for Youth in Short-Term Care Facilities: The Impact of a Comprehensive Behavior Management Intervention

We describe a comprehensive program to train emergency shelter staff in effective methods for dealing with youth who have behavioral and emotional problems; assess the degree to which staff implemented the treatment approach; measure the impact of the intervention on shelter-wide incidents such as out-of-control behavior, runaways, and violence against other youth; and examine pre-post changes in staff experiences at the shelter via anonymous surveys. Overall, the short-term shelter staff indicated adequate implementation of the intervention. The rate of youth incidents at the shelter significantly declined from pre to post assessment. Direct-care staff ratings of their satisfaction with their proficiency in behavior management and teaching youth skills increased significantly from pre to post implementation. These findings suggest that it is feasible to deliver an effective staff-training program to improve the behavior management and social skills of youth residing in short-term care facilities within the child welfare system.     

Enhancing Interpersonal Intimacy in Colombian Gay Men Using Functional Analytic Psychotherapy: An Experimental Nonconcurrent Multiple Baseline Design

A growing body of research suggests that rejection sensitivity, a form of interpersonal guardedness associated with familial rejection and societal bias, is a transdiagnostic risk factor for anxiety and mood disorders in gay men. From a behavioral perspective, rejection sensitivity is conceptualized as avoidance of intimacy as the result of systematic social punishment of vulnerable behaviors. Despite the implications of rejection sensitivity for psychological well-being, clinical psychology lacks specific behavioral interventions for emotional intimacy at the level of the individual. Functional Analytic Psychotherapy (FAP) is a therapeutic approach developed to enhance interpersonal behaviors that promote intimacy and closeness through identification of, and contingent responding to, clinically relevant behaviors.A nonconcurrent between-participants design examined the effectiveness of 4 to 8 sessions of FAP on reducing intimacy-avoiding behaviors and increasing intimacy-promoting behaviors in three Colombian gay men.FAP implementation yielded significant increases in intimacy promoting behaviors (β = 65.65, S.E. = 11.48, p = .0004) with a large effect size calculated by the between-case standardized mean difference (BC-SMD (17.01) = 1.66, CI [0.69–2.73]). The increase in intimacy-promoting behaviors occurred without evidence for reduction or elimination of intimacy-avoiding behaviors.Recommendations for future research include (1) the implementation of longitudinal intensive studies to capture participants' out-of-session behavioral changes and (2) further research to determine FAP’s effectiveness for increasing intimacy-promoting behaviors among other sexual or gender minority individuals.     

From Treatment to Empowerment: New Approaches to Youth Mentoring

Traditional approaches to formal youth mentoring have focused primarily on improving the lives of “at‐risk” youth through the assignment of individual mentors who are typically disconnected from youth's communities. Similarly, research in the field of formal mentoring has emphasized the dyadic relationship between the mentor and the mentee, with less attention paid to the broader relational contexts in which such relationships unfold. The current paper proposes a new framework that expands the scope of mentoring interventions to include approaches that build on and cultivate informal supports and empower youth to identify and reach out to networks of potential supportive adults, thus increasing the reach of youth mentoring.     

A Developmental Approach to the Supervision of Therapists in Training

Supervision is considered essential to therapeutic effectiveness yet trainees frequently report negative supervisory experiences. Although such experiences may be due to inadequate or poor supervision, more often they result from differing needs or expectations among trainees. Thus, supervisors must struggle to determine how to best conduct supervision. We propose that many negative experiences result from a supervisors inattention to the trainees development as a mature individual. By examining the cognitive and emotional development of trainees supervisors are offered a framework from which to select interventions and strategies that encourage rather than discourage trainees.     

Reconciling Spiritual Values Conflicts for Counselors and Lesbian and Gay Clients

Counselors and lesbian and gay clients experience parallel values conflicts between religious beliefs/spirituality and sexual orientation. This article uses critical thinking to assist counselors to integrate religious/spiritual beliefs with professional ethical codes. Clients are assisted to integrate religious/spiritual beliefs with sexual orientation.     

人类积极发展的资源模型——积极青少年发展研究的一个重要取向和领域

积极青少年发展观(Positive Youth Development Perspective,PYD)自20世纪90年代出现以来迅速推动了发展心理学知识的创新与应用,其中发展资源框架(The Developmental Assets Framework)是研究者进行深入探讨与应用研究的一个重要模型.发展资源是指一系列能够有效促进所有青少年获得健康发展结果的相关经验、关系、技能和价值观,本文在这一概念的基础上介绍了发展资源模型的结构、构建与发展基础以及基于该模型的重要假设及实证研究,并在综述研究的基础上探讨了资源模型的未来研究方向.     

Religious Quest Orientation and Anti‐Gay Sentiment: Nuancing the Relationship Between Religiosity and Negative Attitudes Toward Homosexuality Among Young Muslims and Christians in Flanders

Public opinion research has repeatedly shown that religious people generally report more prejudice against homosexuality. However, previous research exploring the general mechanisms that underpin this relationship mostly relied on Christian samples in North America. Studies outside North America are few in number and limited in the forms of religiosity they address. Of all indicators that have been studied so far, a religious quest orientation was found to be the only one negatively related to anti‐gay sentiments. This leaves open the question whether the mechanisms for different forms of religiosity can also be found outside North America. Against that background this research note assesses how religious quest orientation, self‐rated religiosity, religious behavior, and authoritarianism are related to prejudice against homosexuality among Christian and Muslim youth aged 14–23 in Flanders (N = 2,834). This study is the first that investigates the relationship between religious quest orientation and anti‐gay sentiments among Muslims. For both Christians and Muslims, we found that even taking into account a wide range of social background and religious characteristics, having a religious quest orientation is related to less prejudice toward homosexuality.     

Time Limited Treatment and C. G. Jung's Analytical Psychology

Abstract

The work of C. G. Jung has been largely neglected in recent discussions of time-limited psychotherapy. Notwithstanding this state of affairs, this paper argues that much is to be gained from familiarity with Jung's view on treatment. A brief overview of Jung's general system of psychology is presented, and contrasts are drawn to the work of Freud. Several distinctive characteristics of Jung's view of the clinical process are then identified, and a discussion of the course of treatment is provided with a brief reference to a case of Jung's and to the author's experience working with gay men.     

Jungian Perspectives on the Etiology and Treatment of Torture

As increasing numbers of people worldwide suffer the effects of torture and other war trauma, practitioners are challenged to adapt their theoretical backgrounds to their treatment. One such school of thought, Analytical Psychology, contains several premises that can help to decipher the causes of violence and oppression, and provides potentially useful techniques for treating those who have suffered their effects. Practitioners who find themselves in a position to treat survivors of torture and other war trauma can draw upon the basic principles of Analytical ology outlined in this article to enhance their treatment modalities.     

Psychotherapy for the Spectrum of Sexual Minority Stress: Application and Technique of the ESTEEM Treatment Model

Converging evidence points to minority stress as a risk factor that predisposes sexual minority individuals to a variety of negative psychosocial health outcomes, particularly depression and anxiety, substance use, and sexual risk-taking. This paper outlines the techniques and theoretical underpinnings for implementing an emerging empirically supported psychotherapy designed to target the transdiagnostic mechanisms linking sexual minority stress with these outcomes. We outline the essential therapeutic principles, psychoeducation content, as well as session- and homework-based activities that can be adapted for a variety of presenting problems that originate from, and are exacerbated by, minority stress via transdiagnostic minority stress processes. As the development and dissemination of this therapeutic model is still within its early stages, we review the intervention’s empirical support thus far and outline potential directions for future development and dissemination via individual, clinic-based, and societal channels.     

Long-Term Self-Regulation Moderates the Role of Internal Resources for Resilience in Positive Youth Development in Portugal

Abstract

Positive Youth Development (PYD) presents a strength-based conception of transition to adulthood that has been well-supported by literature to date. However, research is needed to integrate the pathways to PYD and the possible moderators. This study aimed to analyze the relationships between internal resources for resilience and PYD and to examine the moderating role of short-term and long-term self-regulation by gender. To reach this overall aim, a cross-sectional study was performed with a national sample of 2700 youths (73.3% girls; M_age = 21.3, SD?=?2.79) from Portugal, who completed self-report measures. Regression-based moderation models were developed. Results indicated that greater presence of internal resources for resilience was related to higher PYD. Long-term self-regulation and gender moderated this relationship, such that a greater effect was observed in men with high levels of long-term self-regulation. These results highlight the need to integrate prevention and promotion paradigms to foster healthy development in youth, as well as the importance of taking self-regulation skills and gender into account in program design.     

Electronic Visibility Management of Lesbian,Gay, and Bisexual Identities and Relationships in Young Adulthood

Visibility management is a process the lesbian, gay, and bisexual-identifying (LGB) people use to manage the extent to which they will identify (“out”) themselves in various contexts such as school, work, family, and home-based settings. The purpose of this study then was to explore LGB persons' experiences of electronic visibility in online environments such as social networking sites and the manner in which LGB persons most commonly monitor their electronic visibility as individuals and in couple relationships. Analysis of the survey responses of 61 young adult participants indicated that this sample felt more positive about their identities overall compared with a national sample and that they frequently reported their sexual orientation online, most often on Facebook. In addition, participants reported online disclosure did not have an effect on their relationship satisfaction. Discussion and implications for research and clinical practice are presented.     

In Search of Meaning: A Preliminary Typology of Gay Male Spiritual Identity Development

Reconciliation of the conflict between religious identity and sexual orientation has been related to a number of psychological challenges (Lease, Horne, & Noffsinger‐Frazier, 2005; Schuck & Liddle, 2001), and little is known about the convergence of spiritual identity, distinctly defined as separate from religious identity, and sexual orientation identity. This qualitative inquiry investigated the process by which 7 Caucasian gay men from a variety of religious backgrounds constructed spiritual identities outside the realm of institutionalized religion. From the findings, the authors hypothesize a typology of spiritual development influenced by religions of origin. Limitations of the study, implications, and future directions in research are also addressed.     

Alfred Adler's Treatment as a Form of Brief Therapy

Alfred Adler was largely overlooked during his era because he viewed people as creative beings in control of their own mental health and resisted the then-standard practice of treating human beings from a pedestal with a normative body of laws. His progressive style of treatment has become more popular in an age when efficient and collaborative treatment is valued for the sake of cost-effectiveness. This article positions Adlerian psychotherapy as a form of brief therapy, effective psychotherapy that takes place in 20 sessions or fewer. The article summarizes the fundamentals of Adlerian theory, outlines the general criteria of brief psychotherapy required by managed care companies, and specifically highlights how Adlerian psychotherapy qualifies as brief psychotherapy.