Psychoanalysis is becoming an impossible profession within the public welfare system in Sweden

Abstract

The preconditions for psychoanalytic practice within the Swedish public welfare system are analyzed in this article. Psychoanalysis remains a one-to-one treatment and relies on the analyst's capacity to use his or her own subjective response. The development of the psychoanalytic process is dependent on unconscious reality, making it impossible to work with a model that has a strict relation between diagnosis, treatment method, and result. Objectivity and the desire to predict treatment outcomes characterize the immanent logic in the complex system of laws and recommendations that affects most practices within the field of medicine. As a consequence of this development, psychoanalysis and psychodynamic therapy are marginalized, since our treatment methods are not adapted to the present industrialization and economization of the medical health sector, with the result that the preconditions for psychoanalytic training have changed dramatically. The exclusion of psychoanalysis from the national health insurance scheme is a demanding challenge at a time when the Swedish welfare model is undergoing fundamental changes.     

Engagement With Self‐Practice/Self‐Reflection as a Professional Development Activity: The Role of Therapist Beliefs

A number of research studies support self‐practice/self‐reflection (SP/SR) as an experiential learning process that facilitates the acquisition of therapeutic skill in a number of cognitive‐behavioural therapy (CBT) competencies and as showing potential as a valuable professional development activity. Engaging therapists to participate in SP/SR programmes is sometimes difficult, and when they are offered the option to participate in SP/SR programmes as part of professional development, relatively few volunteer. This study investigates the role of therapist beliefs about SP/SR as a potential obstacle to engagement. An online survey was developed to assess the strength of 14 commonly held therapist beliefs concerning the consequences of participating voluntarily in a SP/SR programme. Participants were a combined sample of 44 Psychological Wellbeing Practitioners and high‐intensity CBT therapists employed by an Improving Access to Psychological Therapies service in the United Kingdom. Few negative beliefs about SP/SR emerged. The majority of respondents believed SP/SR programmes were relevant to their work situation, but perceived “lack of time” as a significant barrier to participation. Three factors are considered in relation to introducing SP/SR as a workforce professional development activity: (a) The importance of managing therapist perceptions regarding time; (b) SP/SR as a mechanism to increase self‐care and reduce burnout; and (c) The need to focus mental health services' attention on the potential of SP/SR programmes to increase staff morale and improve service delivery.     

Archetypal Identity Development,Meaning in Life,and Life Satisfaction: Differences Among Clinical Mental Health Counselors,School Counselors,and Counselor Educators

Adults pursuing careers in counselor education, clinical mental health counseling, and counselor education (N = 256) participated in a study that examined relationships among archetypal identity development, meaning in life, and life satisfaction. Significant differences between groups existed for 5 archetypal identities, and meaning in life was significantly related to life satisfaction.     

A Code of Ethics for Health Care Ethics Consultants: Journey to the Present and Implications for the Field

For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here.     

20/20: A Vision for the Future of Counseling: The New Consensus Definition of Counseling

With the promulgation of the 20/20: A Vision for the Future of Counseling consensus definition of counseling, there is finally profession‐wide clarity as to what it means to engage in professional counseling. This article describes the development and discusses the implications of the definition: “Counseling is a professional relationship that empowers diverse individuals, families, and groups to accomplish mental health, wellness, education, and career goals.” This consensus definition has been endorsed by 29 major counseling organizations.     

Working With Clients Who Self‐Injure: A Grounded Theory Approach

This article presents the findings of a qualitative study examining the experiences of counselors in their work with clients who self‐injure. Using grounded theory methodology, the authors established 6 categories to explain the counselors’ conceptualization of self‐injury and their process of working with these clients: (a) external factors to self‐injury, (b) defining self‐injury, (c) potential for harm, (d) conditions for treatment, (e) counselors’ reactions to working with clients who self‐injure, and (f) clients’ response to treatment.     

Dual Identities and Their Recognition: Minority Group Members' Perspectives

Minorities may define themselves at a superordinate (e.g., national) level and also at a subgroup (minority) level. However, others' recognition of such dual identifications cannot be guaranteed. This paper investigates how members of a minority (Muslims in the UK) constructed their superordinate and subgroup identities in such a way as to assert a commonality with British non‐Muslims whilst asserting their religious subgroup's distinctiveness. Reporting qualitative data obtained through interviews (N = 28), the analysis explores how British Muslims negotiated concerns over commonality and distinctiveness through describing themselves as being British in a Muslim way. The implications of these self‐definitions for the theorization of dual identities, their recognition, and intergroup relations are discussed.     

The challenge of professional identity for Chinese clinicians in the process of learning and practicing psychoanalytic psychotherapy: the discussion on the frame of Chinese culture

One important element in psychoanalysis, which is derived from Western culture, is individualization: the independency and autonomy of an individual are highly valued. However, one of the significant essences in Chinese culture is that the collective interests transcend the individual interests and the interests of social groups are more important than those of families. Therefore, when learning and practicing psychoanalytic psychotherapy, Chinese clinicians inevitably experience conflicts derived from this difference of cultural values. This article attempts to use a historical perspective to discuss the current challenges of professional identity for Chinese clinicians learning and practicing psychoanalytic psychotherapy and psychoanalysis.     

Comments by ABCT's First Female President on Overcoming the Glass Ceiling

At the annual convention of the Association for Behavioral and Cognitive Therapies in New York City in November 2009, a most interesting panel discussion occurred: Overcoming the Glass Ceiling: A Conversation With the Trailblazers. This article is a written version of my oral presentation at this panel discussion in my role as ABCT's first female president.