Psychodynamic counsellor training integrating difference

Abstract

Psychodynamic counselling has been criticized for being inflexible, authoritarian, antiquated and unresponsive to the issues of modern-day society. Psychodynamic counsellor training is sometimes seen as a poor relation of ‘proper’ psychotherapy therapy training. This article is written by two psychodynamic counselling course trainers who have wresded with the above criticisms and who have striven to deliver a training course that is coherent in its adherence to a psychodynamic counselling model but which embraces equal opportunities issues and takes account of a diverse society. The article focuses on ways in which sexual identity, race and culture are integrated into the course curriculum and indeed into the course philosophy and community. Traditional psychoanalytic interpretations of homosexuality are challenged and multicultural counselling ideas are merged with psychodynamic counselling theory and skills.     

Reflections on a psychiatric placement

Abstract

During a seminar last year, I was teaching a group of counselling students on the subject of depression. One of the students asked me what I thought of referring a depressed client to a psychiatrist. I replied that in my opinion it was better to keep a person out of the psychiatric services as much as possible. This was an opinion I began to reconsider over the course of a six-month psychiatric placement, undertaken as part of an analytic psychotherapy training.     

美国华人移民的异文化压力:特点、影响因素和中介效应

从美国NLAAS的调查数据中直接抽取美国华人移民样本473份,探讨美国华人移民异文化压力的特点、影响因素及中介效应。结果显示:美国华人移民体验的异文化压力较大,且与多因素存在显著相关,英语熟练度、移民时的年龄、移居美国的年数和种族歧视对压力具有显著预测性;社会地位作为中介变量可以有效缓冲美国华人移民的异文化压力。     

Cognitive-behavioral therapy for insomnia in alcohol dependent patients: a randomized controlled pilot trial

In a randomized controlled trial, we evaluated the efficacy of cognitive-behavioral treatment for insomnia to improve sleep and daytime symptoms, and to reduce relapse in recovering alcohol dependent (AD) participants. Seventeen abstinent AD patients with insomnia (6 women, mean age 46.2 ± 10.1 years) were randomized to 8 sessions of cognitive-behavioral treatment for insomnia for AD (CBTI-AD, n = 9) or to a behavioral placebo treatment (BPT, n = 8). Subjective measures of sleep, daytime consequences of insomnia and AD, alcohol use, and treatment fidelity were collected at baseline and post-treatment. Diary-rated sleep efficiency and wake after sleep onset, and daytime ratings of General Fatigue on the Multidimensional Fatigue Inventory improved more in the CBTI-AD compared to the BPT group. In addition, more subjects were classified as treatment responders following CBTI-AD. No group differences were found in the number of participants who relapsed to any drinking or who relapsed to heavy drinking. The findings suggest that cognitive-behavioral insomnia therapy benefits subjective sleep and daytime symptoms in recovering AD participants with insomnia more than placebo. The benefits of treating insomnia on drinking outcomes are less apparent.     

Counsellor conflict in managing the frame: Dilemmas and decisions

An essential feature of psychodynamic counselling is a secure frame for the work that holds boundaries as sacrosanct, both to ensure ethical practice and to provide a vehicle through which unconscious processes can be recognized and understood. Conscious or unconscious attacks on the frame are inevitable in any therapeutic relationship, and provide an opportunity for exploration and insight. However such incidents also have an impact on the therapist who must decide how to respond. In order to understand more about the therapist process when there is an attack on the frame, an investigation was carried out into ways in which psychodynamic counsellors manage the difficulties and dilemmas that arise as they try to hold a secure therapeutic frame. Ten counsellors were interviewed using a semi‐ structured interview format during which they were asked about an instance when the frame was challenged and the process by which it was resolved. The resulting dilemmas were categorized using grounded theory. Three categories of dilemmas emerged a) prior to making a decision about how to deal with it, b) after making a decision, and c), as a result of the outcome of the action taken. The nature of the dilemmas and the process of resolving them are reported and discussed.     

The influence of political climate on job pursuit intentions and the moderating effect of Machiavellianism

Job seekers now have access to a number of internet resources (e.g., social media, chat rooms, and message boards) that provide information about potential employers. These resources provide potential job applicants with extensive amounts of third‐party information about organizations, including information about the extent to which a particular organization's climate can be characterized as being political. Unfortunately, owing to a dearth of research on this topic, it is unclear to what extent such information about an organization's political climate might affect the recruiting process. Therefore, drawing from the Attraction‐Selection‐Attrition model, we considered the extent to which potential job applicants are less (more) likely to pursue jobs in organizations that are perceived as more (less) political. We further identified Machiavellianism as a potential moderator of this relationship, given that this trait reflects the extent to which an individual would “fit” into a highly political work environment. Across three studies, our findings provide evidence that job applicants report being less likely to pursue jobs in organizations characterized by high levels of workplace politics. The results further indicated that Machiavellianism attenuates this negative effect. In light of our findings, we discuss implications for how information that is not controlled by the organization (e.g., information provided by social media or other internet‐based sources) affects job pursuit intentions and the organization's applicant pool.     

Adherence to Asian Cultural Values and Cultural Fit in Korean American Undergraduates' Help‐Seeking Attitudes

Differences in and relationships of Asian cultural values, cultural congruity, perception of the university environment, and help‐seeking attitudes for 1st‐and 2nd‐generation Korean American undergraduates (N = 228) were examined. Women reported significantly higher cultural congruity and more positive help‐seeking attitudes than did men. Asian values adherence negatively predicted help‐seeking attitudes for women and 2nd‐generation students only. Implications for Korean American undergraduate support services are discussed, and suggestions are presented for future research.     

Immediate source-monitoring, self-focused attention and the positive symptoms of schizophrenia

Previous research suggests that tendencies to misattribute one's own thoughts to an external source, as assessed by an immediate source-monitoring test, are associated with auditory verbal hallucinations (AVHs). However, recent research suggests that such tendencies are associated instead with symptoms of thought interference. The main aim of the present study was to examine whether such tendencies are differentially associated with different types of thought interference, with AVHs, or with both. It has also been suggested that external misattributions are especially likely to occur with emotionally salient material and if the individual's focus is on the self. These suggestions were also tested. The positive psychotic symptoms of 57 individuals with a diagnosis of schizophrenia were assessed and they then completed the Self-Focus Sentence Completion blank. Immediately after completing each sentence they were asked to indicate to what extent the sentence was their own. The number of sentences that were not rated as completely their own served as their externalisation score. Externalisation scores correlated significantly with the severity of three symptoms: voices commenting, delusions of being controlled, and thought insertion. In a logistic regression analysis, all three of these symptoms were significantly and independently related to externalisation. Externalisation was not associated with either a negative or a neutral self-focus. Thus tendencies to misattribute one's own thoughts to an external source are associated with AVHs and some, but not all, symptoms of thought interference. The importance for externalisation of self-focused attention and of the emotional salience of the elicited thoughts was not supported.