The talking cure: Wittgenstein's therapeutic method for psychotherapy,by John M. Heaton

This paper offers an outline of the challenges particular to intersubjective approaches to psychoanalytic psychotherapy in South Africa. Past experiences of deeply entrenched and racialized divisions between communities continue to shape the negotiation of power in therapeutic spaces, and affect participants’ capacity to engage freely with the exploration of unconscious communication. Examples are given of the ways in which race, class and gender difference may complicate, hinder or enrich intersubjective psychoanalytic psychotherapy. Some suggestions are made about the kinds of reflective work that need to be undertaken by psychotherapists in order to assume fully the burdens of history and to appreciate fully the opportunities offered by a society in transformation.     

Responding to unemployment and inequalities in income and health

This paper discusses the social and economic context in which counselling and psychotherapy are practised. The use of ‘outplacement counselling’ and personal skills training programmes for dealing with unemployment and redundancy is criticized. It is argued that they involve a form of psychological reductionism which fails to acknowledge socio-economic realities. Research showing a strong link between inequalities of income and physical and mental health is reviewed. It is suggested that counsellors and psychotherapists have a professional obligation to acknowledge the social and economic circumstances likely to contribute to clients' mental distress and avoid the dangers of reductionism.     

European developments

The British National Health Service is 50 years old. The provision of many services has changed considerably through this time in ways that reflect shifts in organization and philosophy. The provision of psychotherapy has been particularly sensitive to these changes in ways that have made it more widely available but also shaped its content. As the pace of change continues to accelerate, some implications of the most recent shifts in philosophy for clinical practice are considered.     

Negotiating ending: A qualitative study of the process of ending psychotherapy

Objectives: When psychotherapy is open-ended, the question of termination is a matter for negotiation. A model based on both content and the process of ending may explain how ‘good enough’ psychotherapies can be brought to ‘good enough’ endings.

Design: Twelve processes of ending were explored through a combination of audio recordings made during therapy sessions and post-therapy interviews with clients and therapists. Therapies had been tailored to the needs of the clients and were based on a broad spectrum of theoretical affiliations.

Methods: A procedure for systematic text condensation was used on a case-by-case basis. Issues surrounding the initiation and negotiation of ending were pointed out in each case and were then compared across cases.

Results: The initiation of ending and exchanges concerned with when and how to end therapy unfolded as a concerted process because both parties seemed to be aware that the theme of ending contained a potential challenge to the alliance. Dual affect regulation, implicit communication and a future-oriented perspective were important features. Structural elements such as schedule changes and temporary breaks served several psychological functions. Therapies seemed to reach ‘good enough’ endings when the client and therapist joined in their efforts to resolve basic ambivalences embedded in the decision to terminate contact with the affirmation of a continuing emotional bond.     

What student psychotherapists want from an experiential group

A study of four thirty-week experiential groups, involving two group conductors and forty-one other group members showed that 90 per cent of students' expectations of change were exceeded, indicating increase in interpersonal learning and, over a longer period, emotional change. the culture of the groups was consistently positive and expressive. There was some evidence that conductors had a similar style which corresponded to that predicted by the group analytic method, and that both showed behaviours which were indicators of ‘good quality' therapy. There were substantial correlations between a positive culture and better than expectation outcome at the end of term one, and good psychodynamic practice by the conductors and outcome at the end of the course.     

The development of therapeutic attitudes during and after psychotherapy training

The aim of this study was to explore changes in psychotherapeutic attitudes of students during training in psychodynamic psychotherapy and the first few years after it. Forty-six students were asked to answer a therapeutic identity questionnaire at three times during training and at one time after it. Twenty-one students completed the questionnaire on all four occasions. The questionnaire assessed attitudes on nine scales relating to beliefs about curative elements in psychotherapy, therapeutic style, and basic assumptions about psychotherapy and human nature. At the beginning of training, students had a clear psychoanalytical orientation, similar to that of their supervisors. From the last year of training, after supervision had ended, and continuing during the post-training period, students distanced themselves from the psychoanalytical orientation and their supervisors toward a more eclectic position. This development may reflect the formation of an autonomous therapeutic identity.     

Positive psychotherapy effectiveness study and quality assurance

Positive Psychotherapy is a form of short-term psychotherapy based on an in-depth psychological approach, resulting from cross-cultural psychotherapy. After a brief introduction to some central elements of the theory of Positive Psychotherapy (PPT), the first results of the effectiveness study will be discussed in this paper. an assessment of alterations in symptoms, as well as changes in the way subjects feel and behave, which occurred in the period of time between the beginning and after the end of therapy will be presented here. In a longitudinal study, patients treated with PPT showed a distinct reduction of symptoms as well as improvement with regard to the way the subjects experience and behave compared to the control group, where no significant changes were observed. an additional cross-section comparison between the post-measures of the prospective assessment of PPT patients and retrospective assessments of PPT patients was carried out. No significant differences between the assessments made directly after finishing PPT and the assessments made within three different time spans after finishing PPT (a) 3-10 months; b) 10 months-4 years; c) 4-5 years) were found. This finding is viewed as an indication of the lasting stability of the therapeutic effects of PPT, which can still be detected up to five years after finishing PPT.     

The person in narrative therapy: a post-structural,Foucauldian account

Having a facial anomaly is more than likely to cause some degree of psychological discomfort. Prior to establishing the most appropriate psychological intervention, there is a need to determine how having an atypical appearance manifests in day-to-day life. Counselling/psychotherapy provides people with the opportunity to talk about their experience - to tell their story. the aim of this heuristic investigation is to determine the lived experience of having a cleft lip and the potential need for counselling/psychotherapy. A heuristic approach was selected as the most appropriate method and one which would enable participants to talk about their experience. It also requires the researcher to have personal experience of the phenomenon. This study highlights the lack of opportunity to talk about how the presence of a facial disfigurement impacts upon life. Even within the family, it seems, the norm was that ‘it' was there, yet not spoken about. Counselling/psychotherapy could therefore provide a form of education. Provision of such a service would give people a choice. A discussion on the limitations of heuristics indicates the importance of the researchers' awareness, of their own experience, in relation to the phenomena being investigated. In conclusion, a counsellor/ therapist is considered to be an essential member of the multi-disciplinary cleft team, caring for persons with clefts from birth to maturity.     

Private psychotherapy training in Italy: A systematic analysis

This paper examines the results of a systematic analysis, organised by the Italian Ministry of Education, University and Research, of private psychotherapy training in Italy. Since 1989, training in psychotherapy in Italy has been governed by a national law which recognises both public and private institutions. While the public system usually comprises approximately 150 students, the private system has grown significantly over time, registering thousands of students in hundreds of schools (for example, 19,123 students in 212 schools in 2011). Systematic analysis variables included geographical distribution, theoretical approaches, training methods, student and teacher characteristics, student’s personal psychotherapy, supervision and apprenticeships. Data were obtained from 92% of the schools. The primary issues discussed in this paper are as follows: the uneven geographical distribution of the schools; the disorderly amalgamation of traditional scientific paradigms; programmes which concentrate on theory and fail to meet international guidelines. One key issue is the excess supply with regard to demand, meaning that recently graduated psychotherapists (especially women) risk underemployment and financial hardship. Student enrolment is also increasingly problematic. This is the first paper to present an in-depth analysis of one European country’s situation in this field. The authors believe it will foster comparison and discussion internationally.     

The religious life and happiness of Protestants involved with the charismatic movement

This research compared the religious lives and happiness of American Protestants involved in the charismatic movement and those not involved in it. Data from the General Social Survey were used to answer the research questions. After controlling for basic demographic variables, the results of multivariate analysis indicated that Protestants involved in the charismatic movement attend religious services and pray more frequently; however, they are not significantly happier than those not involved in the movement. The results of this research suggest that happiness can be enhanced when people participate in religious services frequently; however, the ecstatic worship style and theological perspective of the charismatic movement do not make its participants happier than those who do not participate in the movement.