The effect of contingent reinforcement on target variables in outpatient psychotherapy for depression: a successful and unsuccessful case using functional analytic psychotherapy

The current study investigated a behavior-analytic treatment, functional analytic psychotherapy (FAP), for outpatient depression utilizing two single-subject A/A+B designs. The baseline condition was cognitive behavioral therapy. Results demonstrated treatment success in 1 client after the addition of FAP and treatment failure in the 2nd. This study highlights the challenges in measuring treatment progress and outcome idiographically in this population.     

Who's afraid of the Wolfe couple: the interlocking traumatic scene

Fulfilling intimate relationships require a constant emotional and psychological struggle to disentangle strangleholds created by the interpenetration of unresolved complexes stemming from previous disappointing relational experiences. These complexes may manifest as an encrypted pattern of engagement that each partner brings to the marriage, like a 'malignant dowry'. The dowry box, once opened, releases its nefarious contents to create an extremely complex and entangled drama I call the 'interlocking traumatic scene'. Partners unconsciously entrap each other to play a part in such a scene with double (sometimes multiple) roles for each antagonist. The imaginal space between the two characters can be seen as a projection screen, upon which are superimposed two separate shadow plays, one on each side of the screen. A third play, which is a co-created product of these two individual traumatic scenes, can also be observed. Three plays are performed simultaneously. The defensive systems that the two individuals bring to the equation dovetail together, but the actual interlocking mechanism itself deadlocks in such a way that it seems to have its own malignant presence, a 'malevolent third' (after Ogden 1994). I outline therapeutic interventions using the metaphor of the therapist as 'anti-director' and I introduce my concept of the conjoint selected fact (after Bion 1963 after Poincaré 1952).     

HISTORICAL ASPECTS OF MINDFULNESS AND SELF-ACCEPTANCE IN PSYCHOTHERAPY

We describe some of the historical conditions that made possible Kabat-Zinn’s [(1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacorte] very successful use of mindfulness in his stress management program. The ground had been prepared by the nonjudgmental acceptance of people and symptoms by Humanistic psychotherapists, and by the increasing assimilation of Buddhist ideas into Western psychology and psychotherapy. In addition the word “mindfulness,” as the translation of the Pali sati, came to refer to both the manualized practice that provides the evidence for its efficacy in the hands of Kabat-Zinn and others, and the more complex process of clear comprehension and recollection that is described in his more discursive writings, and is similar to Ellen Langer’s use of “mindfulness” in her book of that name.

Financial and Ethical Considerations for Professionals in Psychology

The profession of psychology is one of many entities affected by the current economic recession. The question of what to do when clients cannot pay agreed-upon charges will need to be answered. Ethical issues related to setting the fee for psychotherapy, insurance coverage, abandonment, pro bono psychotherapy, and lack of resources are addressed in light of the 2002 American Psychological Association's Ethical Principles of Psychologists and Code of Conduct and other relevant literature. The impact of the Mental Health Parity Act on the financial complexities that professionals in psychology now face is also discussed. Several recommendations are made for psychologists, calling them to be proactive in their communities, to be advocates for their clients, and to critically evaluate their financial practices.     

National Survey of Client's Perceptions of Chinese Psychotherapist Practices

The present study is a cross-sectional survey that investigates ethical practices among Chinese psychotherapists from the perspective of a large representative sample of Chinese clients (N?=?1,100). In reports from clients, we found that psychotherapists did poorly in providing informed consent and had other ethical difficulties in the therapeutic setting and with dual relationships. We conclude that Chinese culture, especially Confucianism, had significant impact on the attitudes toward the psychotherapists' ethical practices, which complicated ethical dilemmas. It is important for cross-cultural psychotherapists to become sensitive to the influences of traditional Chinese culture when counseling Chinese clients.     

Ethical Challenges in the Treatment of Individuals With Intellectual Disabilities

The effective provision of psychotherapy services to individuals with intellectual disability requires consideration of ethical issues related to clinical competence, access to services, obligations to multiple parties, guardianship, and appropriate assessment practices. This article provides an overview of major ethical considerations with guidance for clarifying and resolving common ethical concerns. Psychologists are encouraged to expand access to psychotherapy services for this population while maintaining awareness of potential modifications, training needs, and boundaries of professional competence. The authors provide recommendations and resources for effective and ethical treatment of psychotherapy clients with intellectual disabilities.     

A brief introduction to the work of Jean Laplanche

The author proposes an introduction to the work of Jean Laplanche, a well‐known figure of psychoanalysis who recently passed away. He foregrounds what he views as the three main axes of Laplanche's work: firstly, a critical reading method applied to Freud's texts; secondly, a model of psychic functioning based on translation; and, thirdly, a theory of general seduction. Far from being an abstract superstructure, the theory of general seduction is firmly rooted in the analytic situation, as the provocation of transference by the analyst best illustrates. The analytic situation indeed consists in a revival and a reopening of the ‘fundamental anthropological situation’ which, according to Laplanche, is the lot of every human baby born in a world where he or she is necessarily exposed to the enigmatic and ‘compromised’ messages of the adult other. Thanks to the process of analytic de‐translation, the analysand is therefore granted an opportunity to carry out new translations of the other's enigma – translations or symbolizations that might be more inclusive and less rigid than the pre‐existing ones. Incidentally, such a model brings together the purely psychoanalytic and the psychotherapeutic aspects of the treatment.     

Clinicians’ Attitudes Toward Therapeutic Alliance in E-Therapy

Although therapeutic alliance is a crucial factor in face-to-face therapies, no data exist on clinicians’ attitudes towards alliance in E-therapy. The study explored clinicians’ perceived importance of alliance in E-therapy, clinicians’ confidence in their skills to develop alliance in E-therapy, and whether attitudes towards alliance in E-therapy are associated with intended E-therapy practice. Clinicians (n = 106) responded to an online survey. The majority of clinicians considered alliance to be extremely important in both face-to-face therapy and E-therapy. However, clinicians’ ratings of the importance of alliance in face-to-face therapies were significantly higher than their ratings of the importance of alliance in E-therapy. Clinicians reported less confidence in their skills to develop alliance in E-therapy than in face-to-face therapy. Intended E-therapy practice correlated with confidence in one's ability to develop alliance in E-therapy and with previous E-therapy practice.