Introducing the Expectations and Preference Scales for Couple Therapy (EPSCT): Development,Psychometric Evaluation,and Suggested Use in Practice and Research

While it is known that client factors account for the largest proportion of outcome variance across treatment modalities, little is known about how clients’ characteristics affect the process and effectiveness of couple therapy. To further knowledge in this area, we created a brief, practice‐friendly measure, the Expectation and Preference Scales for Couple Therapy (EPSCT). Three self‐report scales assess clients’ Outcome expectations (e.g., I expect our relationship to improve as a result of couple therapy) and role expectations for Self (e.g., I expect to listen to my partner's concerns) and Partner (e.g., I expect my partner to blame me). Three Cognitive‐Behavioral, Emotionally Focused, and Family Systems preference scales use a forced‐choice format to measure the comparative strength of respondents’ preferences for interventions broadly reflective of each approach. A large item pool was developed from relevant literature and clinical experience and refined based on face and content analyses with two panels of experienced couple therapists and researchers. Across four studies with 1,175 participants, the scales’ internal consistency reliabilities were similar and their construct validity was supported with confirmatory factor analyses and significant correlations with several established measures, including expectation measures developed for individual psychotherapy and measures of attitudes toward professional help seeking and valuing personal growth. Across all studies, participants had stronger role expectations for themselves than their partners, although gender effects differed by sample. We discuss how to use the 15‐item EPSCT in clinical practice and in future research as a predictor of couple therapy processes and outcomes.     

Engaging reluctant adolescents in family therapy: an exploratory study of in‐session processes of change

Informed by a trans‐theoretical model of the therapeutic alliance in conjoint family therapy, this exploratory study was the initial stage in a task analysis of critical shifts in adolescent engagement. Specifically, we compared sessions in which a resistant adolescent either did or did not shift from negative to positive engagement during the session. Two successful and two unsuccessful change events were selected from an archival data set based on SOFTA ratings of the therapeutic alliance. The results suggested that one parent element (support) and five therapist elements (structuring therapeutic conversations, fostering autonomy, building systemic awareness, rolling with resistance and understanding the adolescent's subjective experience) seemed critical for successfully facilitating adolescent engagement. The qualitative results were informed by the adolescent's self‐reported target complaints pretreatment, which suggested varying reasons for the teenagers’ active or passive disengagement. Implications for practice and recommendations for future research are offered to continue this line of inquiry.     

Vicariously and directly learned helplessness and effectiveness1

Experiment 1 demonstrated the typical helplessness effect of inescapability on directly participating female subjects. Predictions drawn from social learning theory and comparison level theory on vicariously learned helplessness and effectiveness were then tested in a second study employing the prototypical learned helplessness induction design. In Experiment 2, 180 women served as either observers or direct participants and were pretreated as dyads with escapable, inescapable, or irrelevant noise. Consistent with social learning theory, subsequent instrumental task performance demonstrated facilitation effects of escapability on observers, and the same effect on direct participants also was found. No debilitation effects of vicariously or directly experienced inescapability were obtained. The combined results suggest that the induction of helplessness and effectiveness may depend on the social context in which relative controllability is operative, and are discussed primarily in terms of possible coaction effects.     

Client Gender and Sex Role: Predictors of Counselors' Impressions and Expectations

Researchers of this study questioned: Are clients (male or female) with self-reported “masculine” versus “feminine” role orientations viewed more favorably by counselors? Which is more predictive of the counselor's impressions: the client's gender or his or her sex role orientation? Results suggested that highly masculine and highly feminine clients (regardless of gender) are perceived as more socially skilled and likely to experience a positive therapeutic outcome. Gender did not uniquely predict counselors' impressions. Highly feminine women clients, however, were viewed as more socially skilled than were highly feminine men. On average, clients were viewed as friendly and submissive.     

“Why do (don't) you ask?” transference and the desire (not) to know

One of the criterial distinctions of psychoanalysis is its renunciation of indoctrination through suggestion. In spite of the fact that psychoanalysis is both an organized body of knowledge and a disciplined form of interpersonal influence, it regards an analyst who tells the analysand what to think or do as essentially doing harm by substituting a new form of prejudice and alienation for the preexisting form he is attacking. Even though an analyst regards his knowledge of psychoanalytic theory as adequate at a general level, this "truth" is not an adequate mode of discourse with an individual. Why not? It is a fact that analysands often do not accept an analyst's idea. However, the fundamental problematic of clinical psychoanalysis comes precisely at the point that the analysand would accept the analyst's idea, involving the distinction between a properly psychoanalytic cure and a transference cure. Psychoanalytic theory itself holds that unreflective incorporation of another's idea about oneself comes at the expense of autonomous and spontaneous self-revelation. Despite its resolute pursuit of new truths, the aim of psychoanalysis is less concerned with attaining specific ideas about unrecognized conflicts than it is with achieving a general attitude--that self-understanding requires a capacity to admit dubious and unwanted ideas and feelings that symptoms, dreams, and free associations bring to light. This "psychoanalytic" attitude permits a new type of discourse in which the person recognizes himself or herself through expression, rather than parrotting the analyst's (or others') words, or continuing rigidly to hide the truth of desire for oneself. In the long run, psychoanalysis offers to correct a primary misunderstanding: that one can acquire a comprehensively true image of oneself. As Barratt (1988) emphasizes, this transformation is tantamount to a change in personal epistemology for the analysand and a change in epistemological theory for the culture as a whole. In our culture, most analysts and lay people alike take for granted that the ego is an agent that is to be integrated and strengthened in order to direct one's life. Likewise, the unconscious is commonly regarded as a type of savage alter ego that must be mastered by the ego. According to Lacan's critique, the ego is a snare and a delusion for the patient, however highly commended by society it may be, because its very essence is to furnish the illusion of enduring self-knowledge.(ABSTRACT TRUNCATED AT 400 WORDS)     

Introducing a brief measure of cultural and religious identification in American Jewish identity

The authors conducted 3 studies to develop and investigate the psychometric properties of the American Jewish Identity Scales (AJIS), a brief self-report measure that assesses cultural identification and religious identification. Study 1 assessed the content validity of the item pool using an expert panel. In Study 2, 1,884 Jewish adults completed the initial AJIS and various measures of ethnic identity, collective self-esteem, and religiosity. Using confirmatory factor analyses, the authors selected and cross-validated 33 items that loaded highly and differentially on the 2 theorized latent factors. Study 3 assessed the AJIS's short-term stability and its relation to social desirability. Tests of reliability and construct validity provided initial psychometric support for the measure and confirmed the theorized primary salience of cultural identification. Participants reported significantly more private than public collective self-esteem, and the most Jewish-identified participants reported greater private self-esteem, acculturative stress, and perceived discrimination than did their more assimilated counterparts.     

Psychological Separation,Self-Control,and Weight Preoccupation Among Elite Women Athletes

Given the paucity of research on the prevalence of eating disorders in college athletes, the authors raised two questions: (a) Is weight preoccupation more prevalent among elite women athletes than among their nonathletic counterparts? (b) Does the empirical link between psychological distress and weight preoccupation pertain to elite athletes as well? Results showed that 10.9% of a sample of elite swimmers could be characterized as “weight preoccupied,” a percentage comparable to the general population of college women. In addition, the athletes reported using significantly more benign than punitive self-control strategies, suggesting for them, weight preoccupation is a means to an end rather than an indication of an eating disorder. Implications for counseling are discussed.     

Like a phoenix: the journey toward core-self restoration following paediatric skin-burn injury: a psychoanalytic perspective

Severe and sudden injury to the skin during childhood may damage both the child’s outer appearance and mental state. Such a trauma can provoke a complete and utter breakdown of the core-self and regression to an ‘unintegrated’ state. We present the case of 11-year-old Michael, who played with matches, set a fire and sustained severe burn trauma. Michael was treated in our rehabilitation ward over several months and received skin treatment, physical therapy and psychotherapy. Paediatric burn injury is not only a physical struggle but is often accompanied by intense emotional distress of the child and his family. In describing Michael’s therapeutic process, we show how the restoration of the core-self, alongside the healing of the outer skin, provoke issues concerning early infantile skin formation, normative age-related conflicts and vulnerabilities specific to the child. By integrating psychoanalytic thinking into the clinical work of skin rehabilitation, following burn injury, we demonstrate how the significant relationship between the skin and the self manifest in different practice.