Hope as empowerment model: A client-based perspective on the process of hope development

Abstract

Research on the relationship of client hope to successful therapy outcome underlines the need to discover the processes and conditions when hope flourishes. Snyder’s Hope Theory has been applied to psychotherapy but client subjective experiences are needed to illuminate nuances in the process. The present study examined the trajectory of hope development in psychotherapy using interviews with 18 counseling clients, analyzed using grounded theory methodology. Findings were synthesized into a dynamic model titled hope as empowerment model (HEM) that shares features of Snyder’s Hope Theory. HEM introduces patterns of particular salience to psychotherapy. The compatibility of client preferences with therapist input raised faith in the process of counseling and, in turn, hope in a positive outcome. A number of conditions, including the flexibility of client role preferences and the directiveness of hope-inspiring therapeutic strategies, influenced the nature and strength of client hope. Implications for therapy and positive psychology are considered.     

The function of language in parent‐infant psychotherapy

Parent‐infant psychotherapy, a rather new field in psychoanalysis, raises questions of how to conceptualize the clinical process. Previous publications have used semiotic concepts to account for the therapist's non‐verbal communication and investigated the countertransference, including what the baby might grasp of its variations. The present paper focuses on another argument for using verbal interventions to a baby in therapy; they present him with a symbolic order that differs from that of the parent. The qualitative difference between the parent's and the analyst's address is conceptualized by Dolto's term parler vrai. The therapeutic leverage is not the analytic interventions' lexical content but their message that words can be used to expose conflicts. Thereby, one can transform warded‐off desires into demands that can be negotiated with one's objects. The reasons why this address catches the baby's attention are discussed. A prerequisite for such attention is that the infant brain is prewired for perceiving words as a special communicative mode. Relevant neuroscientific research is reviewed in regard to this question. The presentation relies on concepts by Dolto, Lacan and Winnicott and findings from neuroscience and developmental psychology. It also briefly discusses Chomsky's linguistic concepts in relation to these therapies.     

Supervisory countertransferences and impingements in evaluating readiness for graduation: Always present,routinely under‐recognized

Utilizing detailed, in‐depth material from supervisory hours from around the world (explored in End of Training Evaluation groups), this paper shows that supervisors are subject to multiple, diverse and, at times, ongoing intense countertransferences and impingements on their ability to evaluate candidates’ progress. Multiple external and internal sources of these impingements are explored. It is suggested that supervisory countertransferences and their manifestation in parallel enactments remain under‐recognized, their impact underappreciated, and the information they contain underutilized. It is argued that the recognition, containment, and effective use of the parallel process phenomena and supervisory countertransferences are essential in order to evaluate candidates’ progression and readiness to graduate. Common signals of such entanglements in the supervisor's evaluative function are identified. Three remedies, each of which provides a ‘third,’ are offered to assist supervisors in making effective use of their countertransference: self‐supervision, consultation, and institutional correctives.     

Analytical practice: do the new technologies have an impact?

Through commentary on four clinical vignettes, this article focuses on the anthropological transformations taking place in contemporary society, underlining their differences from the anthropologies of reference of the founding fathers of psychoanalysis. Hybridization between man and machine and the speeding up and alteration of communications which the new technologies promote are now crucial issues facing psychoanalysis. Social media and a 24/7 internet connection have produced deep changes in the way people live and perceive relationships. Analytical practice is not exempt from such issues, which can be particularly insidious, often subtle and difficult to recognize, or even underestimated or ignored by psychoanalysts outright, in order to preserve the illusion of a complete understanding of what unfolds in the analytical space. The authors suggest that such transformations, by (partially) rendering inadequate the theoretical and technical corpus on which the various depth psychologies are founded, require personal engagement on the part of psychoanalysts in the search for new strategies to treat their patients, with the consequent abandonment of the ‘certainties’ offered by sclerotic models of clinical procedure.     

Too close for comfort: the challenges of engaging with sexuality in work with adolescents

This paper explores some of the ways in which sexuality can intrude into the psychotherapeutic relationship and present both opportunities and risks to our work with adolescents. It highlights some of the complexities of this area of the clinical encounter, exploring the particular difficulties encountered by both patient and therapist when sexuality emerges in the transference and countertransference. While we are well aware of the centrality of sexual development during adolescence, far less has been written about the way in which sexuality and the erotic transference emerges and impacts on both patient and therapist. Given the profoundly unsettling nature of this area of work and its capacity to disrupt our thinking and psychic equilibrium, it is easy to underestimate how much we are drawn to avoid, negate and defend ourselves against registering such experiences. Through the discussion of clinical material with two adolescent patients, this paper explores some of these dynamics, addressing some of the technical dilemmas that frequently challenge us in this area of work. These include questions about whether and when it is therapeutically important and effective to take up and interpret the emergence of sexuality more directly in the transference and some of the risks to our patients when we ‘play safe’ and fail to do so. Most importantly, this paper aims to facilitate further thinking and discussion about an important but uncomfortable and easily neglected area of our work.     

A systematic review of the effectiveness of psychoanalysis,psychoanalytic and psychodynamic psychotherapy with adults with intellectual and developmental disabilities: progress and challenges

Objectives: This systematic review aimed to critically appraise the literature on the efficacy and effectiveness of psychoanalysis, psychoanalytic and psychodynamic psychotherapy in adults with intellectual and developmental disabilities (IDD). Method: A systematic search of electronic databases was carried out. The methodological quality of the studies was assessed using a quality assessment tool and comparisons were made with a review of the quality of research on the effectiveness of cognitive behavioural therapy (CBT) for people with IDD. Results: The search yielded 13 papers which provided evidence for the effectiveness but not efficacy of psychoanalytic and psychodynamic psychotherapy; but none were found for psychoanalysis. The quality of the research was generally poor compared to the current research on the effectiveness of CBT. Conclusions: Positive outcomes have been indicated for psychoanalytic and psychodynamic psychotherapy with people with IDD. Larger scale, more controlled research is necessary to advance the evidence base.     

Iraqi refugee men’s experiences of psychotherapy: clinical implications and the proposal of a pluralistic model

The psychotherapy experiences of a sample of Iraqi refugee men, in later stages of exile, were explored with the aim of shedding some light on how this client group can experience therapy. Ten adult male Iraqi refugees – who had lived in Sweden for at least five years and had been psychotherapy clients at some point during that time – were recruited for this study. Using individual semi-structured interviews (in Arabic), three main areas were explored with each participant: (1) reasons for seeking psychotherapy; (2) perceptions of the psychotherapy professional; and (3) experiences of the psychotherapy process and outcome. The interviews were then translated into English, transcribed, and then analysed using Interpretative Phenomenological Analysis (IPA). Most participants/clients described exile-related stressors as their main reason for seeking psychotherapy, but some described distress due to a combination of pre-migration trauma and post-migration stress. They also found some aspects of therapy to be positive (mainly verbalising ones thoughts and feelings, and feeling less marginalised) and some negative (mainly experiencing racist or culturally insensitive treatment by therapists, and experiencing a lack of competence and transparency in therapists). The findings were explored in terms of clinical implications and a pluralistic model was proposed to address the identified needs.     

艺术治疗的概念、发展及教育

综述了国内外近10年来关于艺术治疗的文献资料,回顾了艺术治疗的概念、学科范围界定、应用、发展,比较了中西方艺术文化差异,同时对于艺术治疗与健康和疾病的关系,及其机理等进行了探讨.也对国外艺术治疗在高等院校中的课程设置、讲解内容等进行了阐述.根据作者多年的研究和教育实践,试图探索出中国艺术治疗学科体系的构建框架.     

唯心主义与癔症

从唯心主义角度分析癔症病因,为揭示癔症形成提供新的思路.说明唯心主义认知观在癔症的形成中有不可忽视的作用.因此,改变癔症患者的唯心主义认知现对治疗癔症患者有重要的作用.