On the mechanisms and effects of feedback in group psychotherapy

Group psychotherapists commonly see feedback as one of the primary mechanism that furthers the goals of the group. This paper will summarize the research that has been done on the mechanisms leading members to produce feedback, the factors that induce members to accept feedback (for example, feedback valence and timing), and the effects of feedback on outcome and aspects of group process such as group cohesion. The article will address the practical implications of these findings for the interventions of the group psychotherapist. As will be discussed, the emphasis on the importance of feedback in the interpersonal group psychotherapy literature exceeds the programmatic research that has been done on basic questions. This paper will identify major lines of future investigation that could yield findings critical to the delivery of effective group psychotherapy such as the information processing sequences that underlie feedback delivery and reception.     

The catharsis hypothesis,aggressive drive,and the reduction of aggression

The import of the concept of aggressive drive for the construct of catharsis, particularly the trend toward alternatives to drive concepts, is considered. Three conceptions of catharsis are distinguished—the Dramatic model, the Clinical model and the Experimental model. The Dramatic and Clinical models are seen to focus on affective engagement and change, while differing in the vicarious nature of the cathartic experience, in the degree of cognitive representation entailed, and in the nature of the interpersonal context. The Experimental model is seen to be addressed to the more general problem of aggression reduction through aggressive acts. The Dramatic and Clinical models of catharsis are viewed as more specific and germane, and the hypothesis is proposed that catharsis obtains in the case of inhibited rather than persistent or unresolved affect.     

L’évaluation psychologique en situation transculturelle : une révision de la littérature

Human migration provokes transcultural clinical encounters that may challenge the way clinicians see themselves and how they proceed in their usual practices. In the field of psychology, psychological assessment is an important tool to better understand the patients’ needs and to design psychological interventions. Considering that most diagnostic tests and manuals have been developed in the Western context, the application of these tools with other populations remains controversial. The present literature review aims to describe the state of current knowledge on psychological transcultural assessment. Specifically, we will address: (1) the use of psychological tests in transcultural contexts, (2) the development of the Cultural Formulation Interview (CFI, DSM-5) and (3) the clinical interview: language, therapeutic relationship and participation of interpreters. In the first section, we discuss the international norms for scales and tests translation and adaptation, as well as the cultural issues that may bias the test’ application and interpretation. In the second section, we describe the creation of the CFI, and its use in recent studies. The CFI is composed by four clusters: (1) cultural definition of a problem, (2) cultural perceptions of cause, context, and support, (3) cultural factors affecting self-coping and past help seeking, and (4) cultural factors affecting current help seeking. The revised studies indicated that the CFI has a positive impact on the cultural sensibilization of mental health professionals, also improving the relationship between the patients and professionals. The cultural formulation may also prevent misdiagnosis. Beyond the use of tests and structured interviews, the clinician also faces other challenges during a transcultural assessment. We discuss in the third section the transferential and countertransferential relationship in a transcultural situation. Several elements may influence this relationship, at an individual, institutional and societal level. The evaluation of these elements may allow the clinician to better understand results of the psychological assessment. We also describe the current guidelines for the use of interpreters during health consultations in France. In conclusion, several advances have been made in the field of transcultural psychological assessment, among other things the development of guides for good translation and cultural adaptation of tools, as well as the integration of cultural issues into the DSM. However, research and changes in clinical practice are still needed, as the evaluation of cultural biases in cognitive tests and the expansion of cultural competences training among clinicians.     

Qu’est-ce que les professionnels dévoilent d’eux-mêmes dans la relation thérapeutique avec les personnes atteintes de schizophrénie ?

IntroductionHealth professionals’ self-disclosure is a common practice, but there is still controversy regarding when it is appropriate, what the extent and content of self-disclosure should be, and what the clinical consequences are.ObjectivesThis qualitative study aimed to investigate self-disclosure in health and social-care professionals.MethodThirteen in-depth interviews with group leaders of an intervention to improve pleasure and motivation in schizophrenia. The interviews were subjected to thematic analysis.ResultsProfessionals describe their personal disclosures as authentic sharing of lived experiences. From a content point of view, professionals select simple events from their personal or professional life, which they find easy to share with patients, in a group. The selection criteria for these experiences mainly concern the therapeutic value and are formulated in terms of relevance of the content and the usefulness envisioned for the patient as well as authenticity. Self-disclosure generates a redefinition of the places in interaction and a more egalitarian relationship.ConclusionSelf-disclosure is found to be a tool for developing and maintaining the therapeutic relationship. Further studies of the phenomenon would be useful to design training and supervision for professionals.     

La photo-expression : un outil pour accompagner le patient en éducation thérapeutique et pour évaluer son évolution

IntroductionIn therapeutic patient education (TPE), photoexpression is often used by psychologists in order to work on patients’ perceptions and experiences, especially in group workshops.AimThe aim of this study was to explore diabetic patients’ discourse during two photoexpression group workshops at the beginning and the end of a TPE program.MethodSeventeen patients took part in this study. A lexicometric analysis was performed on their discourse during the two group workshops (Alceste® software).ResultsFor the first workshop, the analysis yielded two classes: the place of diabete in daily life as well as psychic and social functioning. For the second workshop, the analysis also yielded two classes: self-management and adjustement, as well as program experience and return back home.ConclusionThe results show an increase in adaptation skills and particularly in self-efficacy, motivation, positive emotions, perhaps illness acceptance. Photoexpression shows to be a very interesting tool in TPE to accompagny patients but also evaluate their discourse evolution during a TPE program.