The relationship of clients’ social class to early therapeutic impressions

Using case vignettes that differed in the presentation of the client's social class, the influence of social class on therapeutic impressions was studied in the context of just-world beliefs. Results suggested that (1) participants with higher levels of belief in a just world saw poor and working-class clients as more unpleasant to work with and more dysfunctional and (2) working-class vignettes were associated with the lowest predictions of session depth and smoothness. The findings suggest that counselors may respond differently to clients based on their social class, and in a way that negatively predisposes them toward work with poor and working-class clients.     

Counselling and psychotherapy,complementary and alternative medicine and the future of healthcare

The counselling and psychotherapy profession is undergoing considerable change as a result of government intervention in the form of regulation, funding and efficacy research. In this paper we argue that these changes, even though they challenge some of the basic ways of thinking which have come to underpin the profession since its inception, also offer an opportunity to stimulate debate and thought in regard to how the profession might contribute to the development of healthcare systems in the future. We argue that this could be enhanced if therapists can learn from the experience of practitioners in the field of complementary and alternative medicine (CAM), which has been experiencing similar changes in recent years. Indeed, both fields of clinical activity adopt many similar underlying clinical principles and, according to Samuels (2001), have similar political outlooks. With reference to anthroposophic psychotherapy which, as well as being a form of psychotherapy, is also part of a ‘whole systems’ approach to CAM, we will examine those characteristics of psychotherapy and CAM that can inform the thinking of healthcare systems as a whole.     

心理治疗与普通医疗的平等性

心理治疗与普通医疗的平等性是美国心理健康服务系统面临的一个主要政策问题,强调健康保险应为心理健康和物质滥用障碍提供与普通医疗相同的承保范围。近20年来,平等性立法在美国得到了较快发展,并取得了一定效果。但由于立法本身存在的局限性及心理健康服务需求与提供双方的多重因素影响,平等性立法的实施及对其效果的评估仍存在一定困难。借鉴平等性立法的经验,得出了一些关于我国心理健康服务发展的启示。     

"Without being in psychoanalysis I would never have dared to become pregnant": psychoanalytical observations in a multidisciplinary study concerning a woman undergoing prenatal diagnostics

As is well known, Freud described the clinical practice of psychoanalysis as the 'loam' of his cultural-theoretical work, an assessment which is shared by many psychoanalysts up to the present, including the authors of this paper. The complex interplay between unconscious phantasies on the one hand, and the real experiences arising from the new possibilities opened up by prenatal diagnostics on the other, is described with reference to a report of an intensive, long psychoanalysis with an analysand from a family burdened with a genetically transmitted illness (haemophilia). The holding and containing function of the analyst enabled this analysand, despite traumatic experiences with the miscarriage of a healthy child triggered by a prenatal diagnosis and the later abortion of a haemophiliac baby, nevertheless to have the courage to go through another pregnancy and give birth to a healthy girl. The intensive clinical investigation of the unconscious phantasies, conflicts and traumas around the prenatal diagnostics proved to be not only therapeutically fruitful for the analysand, Ms F. It also facilitated insights into those individual chances and risks which appear to be an integral part of the opportunities presented by todays prenatal diagnostics and, through them, it lead to a cultural-critical look at the ambivalence of medical-technical progress. These insights, which are only attainable through psychoanalysis, can represent a distinctive contribution of psychoanalysis to a multi-disciplinary dialogue with medical practitioners, geneticists, ethicists and health policy-makers. By referring to a large EU study on 'Ethical Dilemmas due to Prenatal and Genetic Diagnostics', this paper gives a practical example of such a discussion. Ms F. was psychoanalytically interviewed as part of this study, 16 years after the conclusion of her analysis. The summary of these interviews, which is set against the account of the treatment, offers an impressive insight not only into the long-term effects of a psychoanalysis under very particular personal circumstances, but also into the lasting consequences of decisions made in the context of prenatal diagnostics. Finally, the results of the individual case study are brought together with the clinical outcomes of the EU study, and some considerations are formulated concerning the protective and risk factors facing women during and after prenatal diagnostics. The paper is an appeal to psychoanalysts, with their specific competence in dealing with unconscious phantasies and conflicts and their high level of professionalism in dealing with traumatised patients, to get involved in fresh dialogue with prenatal diagnosticians and their patients.     

Infant observation and the French model

Psychoanalytic training in the French Societies belonging to the International Psychoanalytic Association does not grant any place to the observation of babies as it exists in certain societies of other countries. Infant observation is even the object of sharp critiques by eminent French theoreticians. The reasons given for condemning infant observation and refusing to give it any place in the training programme lie in theoretical positions concerning the very nature of the Freudian discovery and its interpretation, which is more idealistic than empirical. The author discusses these reasons while drawing attention to the frequent confusion between a reference to empiricism and a reference to the experimental. The fear of a psychologizing deviation of metapsychology and of a denial of psychic reality leads, in the French model, to placing the emphasis on personal analytic experience during the candidate's psychoanalysis, prolonged by supervisions. It excludes any academic teaching of metapsychology or of related disciplines. The confusion between the empiricism of Esther Bick's method and the recourse to experimental procedures in developmental research stands in the way of making a place for infant observation and of recognizing its training value, not so much for the acquisition of new knowledge or the validation of metapsychological models, as for its usefulness in developing a mode of psychoanalytic observation and an increase in the candidates' containing capacities.     

The therapeutic action of psychoanalysis

Psychoanalysis does not seek to get rid of symptoms but to question them as witnesses of psychic functioning and as formations of the unconscious. Whatever their nature may be, it is a question of analysing their causes and their functions as they appear and develop during the course of the analytic process. The latter is activated by the transference relationship induced by the method within a specific setting. The aim is to bring about liberating psychic transformations. The extension of the indications and modifications in the expression of psychic suffering have led to the development of psychotherapies. Their relations with psychoanalysis proper have been evolving constantly since the first advances by Ferenczi. This long historical evolution has resulted in their redefinition. Psychoanalytic practices are currently considered to require, depending on the case, different settings and different modes of psychic involvement from the analyst. Contemporary psychoanalysis places emphasis on the internal setting of the analyst (thus his training), analysis of the countertransference, and the risk of anti-analytic aberrations.     

Effects of access to a stimulating object on infant behavior during tummy time

Placing infants in a prone position for "tummy time" often is recommended to ensure appropriate infant development and to combat the effects associated with infants spending extended periods of time in a supine position. However, tummy time may be associated with inappropriate infant behavior such as crying and noncompliance. We provided continuous access to a preferred stimulus to decrease negative vocalizations and to increase the duration of an infant's head being elevated during tummy time.     

Family myth,the symbolic realm and the ancestors

Abstract: This paper¹ takes the shape of a diptych. The first part explores the ancestors as embodied ghosts, internal objects or as mediated through ancestral heritage, as these aspects intertwine in a Möbius strip. The second part looks at ancestral heritage and the different ways in which ‘family myth’ appears in a Jungian context and in Systemic Psychotherapy (family therapy). Both share an interface through the current paradigm shifts towards mutual reflexivity in patient and therapist and a focus on the interpersonal space. The ancestors give substance to the eternal riddle: ‘from whence do we come, who are we and where do we go’, which connects past, present and future. Our ancestors are part of our minds, perhaps in the way Damasio (2010) postulates that ancestral experiences mediated through culture shape our brains. The leitmotiv of individuation through mimesis (sameness) and alterity (difference) runs through both parts.     

Formative evaluation of the transition to postgraduate study for counselling and psychotherapy training: Students' perceptions of assignments and academic writing

Background: Transition to postgraduate study has received little attention and it is often assumed that little adjustment is needed. Focus: This article focuses on the academic writing aspect of the transition to postgraduate study for counselling and psychotherapy students on a British Association for Counselling and Psychotherapy (BACP)‐accredited course. Method: A two‐year formative evaluation was used to elicit students' views on how they experienced the transition to postgraduate study, and to identify what was most and least helpful to students in managing this transition. Results: The findings showed that there was a significant transition, which 63% of students found difficult. Timetabled and integrated, subject specific, academic support is recommended to assist students with their learning needs.     

Motivation as a predictor of outcomes in school‐based humanistic counselling

Background: Recent years have seen a growth in the provision of counselling within UK secondary schools, and research indicates that it is associated with significant reductions in psychological distress. However, little is known about the moderators and mediators of positive therapeutic benefit. In the field of adult mental health, motivation has been found to be one of the strongest predictors of therapeutic outcomes, and it was hypothesised that this may also be a predictor of outcomes for young people in school‐based counselling services. Aims: To assess the relationship between young people's motivation for counselling and its effectiveness within a secondary school setting. Sample: Eighty‐one young people (12–17 years old) who attended school‐based humanistic counselling services in Scotland. Method: Clients completed a measure of motivation for counselling at the commencement of their therapeutic work and a measure of psychological wellbeing at the commencement and termination of counselling. Results: Motivation for counselling was not found to be significantly related to outcomes. Discussion: The results indicate that the association between motivation and outcomes may be weaker in young people as compared with adults. However, a number of design factors may also account for the non‐significant findings: insufficient participants, marginal reliability of the motivation measure and social desirability effects.