The Ethics of Mandatory Personal Psychotherapy for Trainee Psychotherapists

Although the psychotherapist's personal psychotherapy has received considerable research attention in recent years, little systematic investigation of the ethical issues involved has been published. This article provides a rigorous interrogation of mandatory personal psychotherapy (MPP) as a training requirement for mental health professionals, a topic that remains ethically contentious. The article begins with a discussion of why MPP is an explicitly ethical issue, before debating the ethics of MPP under six questions, each worded to capture a salient ethical issue relevant to the appropriateness of making personal treatment a mandatory training requirement. Using principle, virtue, and care ethics perspectives, the arguments for and against MPP are critically investigated. The article concludes with an ethical position statement.     

The therapeutic community in the local community: Social networks between therapeutic community and supported housing

In this paper, the authors present a model for therapeutic community programmes for those with severe and enduring mental ill health, based on social networks. These programmes have given birth to a range of therapeutic community which are, in fact, an innovative form of group psychotherapy. These new model do not depend on communal living. Some are groupings of apartments, others day units. Work schemes also feature here. And yet, as the authors outline, various components need to be present if these are to be considered genuine therapeutic communities and not just supported housing schemes. Additionally, a certain kind of training and clinical supervision is needed for the staff.     

Everything you always wanted to know about therapy (but were afraid to ask): Social,political, economic and clinical fragments of a critical psychotherapy

Three seemingly consensual propositions concerning psychotherapy and counselling are examined critically. All turn out to be unreliable, tendentious and even damaging: (i) Psychotherapy and counselling can be free and independent professions provided therapists, acting together, fight for them to be that way. (ii) Psychotherapy and counselling are private and personal activities, operating in the realms of feelings and emotions – the psyche, the unconscious, affects rooted in the body. Above all other factors, the single most important thing is the therapy relationship between two people. (iii) Psychotherapy and counselling, and psychotherapy are vocations, not jobs. Therapists are not only motivated by money. In developing his critiques of these propositions, the author utilizes social, political and economic perspectives. The author reviews new clinical thinking on the active role of the client in therapeutic process and suggests that a turn to the legendary figure of the Trickster might be of benefit to the field. The author locates his arguments in his experience of the politics and practices of psychotherapy and counselling, and engages in self-criticism.     

Jung's views on causes and treatments of schizophrenia in light of current trends in cognitive neuroscience and psychotherapy research II: Psychological research and treatment

Jung was the first to emphasize the importance of psychological factors in the aetiology and treatment of schizophrenia. Despite this, and other seminal contributions, his work on schizophrenia is almost completely ignored or forgotten today. This paper, a follow‐up to one on Jung's theories of aetiology and symptom formation in schizophrenia (Journal of Analytical Psychology, 59, 1) reviews Jung's views on psychological approaches to research on, and treatment of, the disorder. Five themes are covered: 1) experimental psychopathology; 2) attentional disturbance; 3) psychological treatment; 4) the relationship between the environment (including the psychiatric hospital) and symptom expression; and 5) heterogeneity and the schizophrenia spectrum. Review of these areas reveal that Jung's ideas about the kind of research that can elucidate psychological mechanisms in schizophrenia, and the importance of psychotherapy for people with this condition, are very much in line with contemporary paradigms. Moreover, further exploration of several points of convergence could lead to advances in both of these fields, as well as within analytical psychology.     

Motherhood in adolescent mothers: Maternal attachment,mother–infant styles of interaction and emotion regulation at three months

Early motherhood is considered a risk factor for an adequate relationship between mother and infant and for the subsequent development of the infant. The principal aim of the study is to analyze micro-analytically the effect of motherhood in adolescence on the quality of mother–infant interaction and emotion regulation at three months, considering at the same time the effect of maternal attachment on these variables. Participants were 30 adolescent mother–infant dyads compared to 30 adult mother–infant dyads. At infant 3 months, mother–infant interaction was video-recorded and coded with a modified version of the Infant Caregiver Engagement Phases and the Adult Attachment Interview was administered to the mother. Analysis showed that adolescent mothers (vs. adult mothers) spent more time in negative engagement and their infants spent less time in positive engagement and more time in negative engagement. Adolescent mothers are also less involved in play with their infants than adult mothers. Adolescent mother–infant dyads (vs. adult mother–infant dyads) showed a greater duration of negative matches and spent less time in positive matches. Insecure adolescent mother–infant dyads (vs. insecure adult mother–infant dyads) demonstrated less involvement in play with objects and spent less time in positive matches. To sum up adolescent mother–infant dyads adopt styles of emotion regulation and interaction with objects which are less adequate than those of dyads with adult mothers. Insecure maternal attachment in dyads with adolescent mothers (vs. adult mother infant dyads) is more influential as risk factor.     

Mothers who are securely attached in pregnancy show more attuned infant mirroring 7 months postpartum

This study contrasted two forms of mother–infant mirroring: the mother's imitation of the infant's facial, gestural, or vocal behavior (i.e., “direct mirroring”) and the mother's ostensive verbalization of the infant's internal state, marked as distinct from the infant's own experience (i.e., “intention mirroring”). Fifty mothers completed the Adult Attachment Interview (Dynamic Maturational Model) during the third trimester of pregnancy. Mothers returned with their infants 7 months postpartum and completed a modified still-face procedure. While direct mirroring did not distinguish between secure and insecure/dismissing mothers, secure mothers were observed to engage in intention mirroring more than twice as frequently as did insecure/dismissing mothers. Infants of the two mother groups also demonstrated differences, with infants of secure mothers directing their attention toward their mothers at a higher frequency than did infants of insecure/dismissing mothers. The findings underscore marked and ostensive verbalization as a distinguishing feature of secure mothers’ well-attuned, affect-mirroring communication with their infants.     

Patterns of mother–infant interaction from 3 to 12 months among dyads with substance abuse and psychiatric problems

The aim of this study was to investigate the development of mother–infant interaction patterns from 3 to 12 months among three groups of mother–baby pairs recruited during pregnancy: one group from residential substance abuse treatment (n = 28), a second group from psychiatric outpatient treatment (n = 22), and a third group from well-baby clinics (n = 30). The mother–infant interaction at 3 and 12 months was assessed by the Parent–Child Early Relational Assessment (PCERA), which consists of maternal, child and dyadic subscales (Clark, 2006). Linear mixed effects models were used to analyze group differences and the changes in mother–infant interaction from 3 to 12 months.At 3 months, pairwise comparisons showed that the group with psychiatric problems had significantly more difficulties in the mother–infant interaction than the two other groups. The group with substance abuse problems was not significantly different from the two other groups. At 12 months, the mother–infant pairs in the substance abuse group showed significantly more relational disturbances than the non-clinical pairs, as well as a poorer affective quality of interaction than the dyads in the group with psychiatric problems. Analysis of change from 3 to 12 months showed that difficulties in the interaction increased among the mother–baby pairs in the substance abuse group, while improvements were displayed in the two other groups. These results underline that mother–infant pairs at double risk due to maternal substance abuse and other non-optimal factors, are in need for long-term follow up in order to prevent the development of negative interactional patterns.     

Mother–infant mutual eye gaze supports emotion regulation in infancy during the Still-Face paradigm

This study was designed to examine the sequential relationship between mother–infant synchrony and infant affect using multilevel modeling during the Still Face paradigm. We also examined self-regulatory behaviors that infants use during the Still-Face paradigm to modulate their affect, particularly during stressors where their mothers are not available to help them co-regulate. There were 84 mother–infant dyads, of healthy full term 4 month old infants. Second-by-second coding of infant self-regulation and infant affect was done, in addition to mother–infant mutual eye gaze. Using multilevel modeling, we found that infant affect became more positive when mutual gaze had occurred the previous second, suggesting that the experience of synchronicity was associated with observable shifts in affect. We also found a positive association between self-regulatory behaviors and increases in positive affect only during the Still-Face episode (episode 2). Our study provides support for the role of mother–infant synchronicity in emotion regulation as well as support for the role of self-regulatory behaviors in emotion regulation that can have important implication for intervention.     

Counseling and Guided Self‐Help Outcomes for Clients With Bulimia Nervosa: A Meta‐Analysis of Clinical Trials From 1980 to 2010

This meta‐analysis included 111 clinical trials exploring the effectiveness of counseling/psychotherapy and guided self‐help approaches in the treatment of bulimia nervosa. In general, single‐group studies supported higher efficacy of counseling/psychotherapy, whereas wait‐list, treatment‐as‐usual, and placebo studies indicated both approaches were equally effective at termination (posttest) and follow‐up in altering binging, purging, laxative use, and self‐reported bulimia or body dissatisfaction perceptions in nearly all comparisons.     

Multicultural Counseling Beyond the Relationship: Expanding the Repertoire With Techniques

Multicultural counseling approaches variously focus on the counseling relationship. Relatively few discuss clinical techniques and strategies to any significant extent. This article explores enhancing multicultural counseling by offering an array of techniques and strategies based on addressing oppression and increasing psychological freedom. Techniques offered seek to internally free a person cognitively, affectively, and systemically using the Precursors Model of Change (Hanna, 2002). The goal is to help set a person free from oppressive, discriminatory systems and individuals.