Course of Treatment During a Cohort-Based Inpatient Program for Posttraumatic Stress Disorder

This study examined one group of veterans with post-traumatic stress disorder (PTSD) over the course of a four month inpatient treatment program. The aim of the study was to examine treatment process factors that may contribute to the generally poor outcome reported in previous studies. Group members made weekly ratings in the domains of PTSD symptoms, morale, interpersonal relationships, and physical problems. Results contrasted with clinical assumptions usually made regarding the treatment process in these programs. Despite an appearance of cohesion among group members, variation of scores on functional domains was explained largely by individual differences. Progress through the program showed a strongly linear pattern, with no phase effects. Somatic complaints did not increase during the phase when traumatic material was explored. Degree of improvement or worsening was best predicted by level of PTSD symptoms at admission, indicating that more symptomatic veterans did worse in the program. Additional factors of race, combat exposure, childhood abuse, and application for disability had no effect on the process variables measured.     

A Systems/Dialectical Model of Supervision: A Symbolic Process

Although there has been a proliferation of models of supervision in the marriage and family therapy literature recently, most tend to focus on methods rather than on the process of supervision. The model presented here is grounded in developmental concepts and focuses on student learning through a dialectical process of cognitive and emotional growth and incorporates three stages: 1) developing relationships; 2) breaking impasses, and 3) orchestrating changes. Students discover that supervision becomes isomorphic with relationship issues that arise in their therapy sessions. Dialectical in nature in that each stage is characterized by the resolution of contradictory emotions, the supervision process helps supervisees experience emotional shifts in their interactions with others, referred to as emotional restructuring.     

Is Therapeutic Alliance Influenced by a Feminist Approach to Therapy?

Although the feminist critique of marriage and family therapy has been a significant part of the literature for many years, its impact has been blunted by two criticisms. The first suggests that the feminist critique lacks empirical support. The second suggests that the feminist critique promotes an alliance with women clients at the expense of men. The first criticism has been addressed in recent years. The present study examined the relationship between feminist principles and therapeutic alliance. Results suggest that feminist principles actually enhance therapeutic relationship for men clients but has no effect on therapeutic relationship for women clients.of the Marriage and Family Therapy Program     

Look Who's Talking: Measuring Self-Disclosure in MFT

While self-disclosure plays a prominent role in the development and maintenance of the therapeutic relationship, most marriage and family therapy clinical research fails to include measures of self-disclosure. A factor analysis of Chelune's (1976) Self Disclosure Situations Survey (SDSS) reduces the number of items in this measure from 20 to six. Researchers are encouraged to consider conducting clinical research with specific attention to the construct of self-disclosure. The revised SDSS could easily be added as part of the self-report information collected in clinical studies.     

Recapturing the Person in the Therapist: An Exploration Of Personal Values, Commitments, and Beliefs

The authors encourage an approach to personal exploration that attempts to recapture the person in the therapist. Person in the therapist training is aimed at helping therapists discover or re-capture their own values, beliefs, and personal ethics. A personal approach to theory development and the practice of therapy is offered and discussed. Activities to recapture the person in the therapist focus on developing a personal theoretical orientation, exploring the values of family therapy theories, and exploring the values of the stance of the therapist in the therapy session. The authors offer their own personal beliefs throughout the article and encourage further development of these issues.Co-director of The Re-Authoring Center and a PhD student in Marriage and Family Therapy at Iowa State UniversityCo-director of The Re-Authoring Center and a PhD student in Marriage and Family Therapy at Iowa State University     

Case Report: Object Relations Family Therapy as a Model for Genetic Counseling

Object relations family therapy (ORFT) is a psychoanalytically based approach for the treatment of couples and families which stresses the importance of past relationships. The therapist assumes a parentlike role and provides a holding environment in which clients can explore unconscious motivations. This paper will discuss the applicability of this method to genetic counseling. The case of a couple seen for recurrent trisomies will be presented and used as an example to discuss how ORFT might serve as a framework in a genetic counseling session.     

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.     

Exploring Decision Making Around Therapist Self‐Disclosure in Cognitive Behavioural Therapy

Background

Therapist self‐disclosure (TSD) usage varies greatly among different psychotherapy orientations. Anecdotal evidence seems to suggest that there are reasons for its judicious use, and a small number of researchers have proposed guidelines for how TSD should be used to help therapists across psychotherapy models make decisions around disclosure. However, there is almost no literature specifically exploring how cognitive behaviour therapy (CBT) practitioners make decisions around employing TSD within the CBT framework.

Objective

This study aimed to explore how experienced CBT practitioners make decisions around TSD.

Method

In‐depth qualitative interviews were conducted with six clinical psychologists who were trained and experienced in CBT, and the interviews were analysed thematically.

Results

There were two overarching themes in terms of how they made decisions to self‐disclose: (A) the rules for TSD use, which included sub‐themes (a) it must have a clear purpose, (b) it must fit, (c) the therapist must maintain boundaries, and (d) the therapist must always reflect on his/her use of TSD; and (B) how they use TSD, which included subthemes of (a) using it as a tool for change and (b) using it to manage the therapeutic relationship.

Conclusion

Participants’ decisions on whether or not to self‐disclose were strongly influenced by the CBT model, and this process went beyond what is suggested in the transtheoretical literature. Understanding this process may lead to the development of CBT‐specific guidelines for making TSD‐related decisions.     

音乐治疗在社会工作中的运用及其发展前景探析

音乐治疗以音乐的各种要素,即节奏、旋律、音色、音高等作为干预手段对人的心理、生理产生影响,是对音乐传统功能之外的拓展。社会工作在实务工作中可以吸纳音乐治疗方法,将之运用到儿童、妇女、老年人、移民等群体,结合社会工作专业的理论,改善服务对象心理行为问题,协助个体、群体解决具体困难,从而丰富社会工作实务方法。未来,社会工作专业应引入音乐治疗专业人才,在社工机构建立完整音乐治疗流程、体系,结合中国民众的特点以及中国传统音乐的特色,走中国特色音乐社会工作专业化道路。

     

Evaluation of a Combined Cognitive Behavioural Therapy and Interpersonal Process Group in the Psychotherapy Training of Clinical Psychologists

It is now widely acknowledged that both content and process elements of psychotherapy play a part in client treatment outcomes. Despite this, there are pressures on Australian clinical psychology training programs to teach evidence‐based approaches in a relatively short time frame. Producing clinical psychology graduates who have an adequate level of competence in evidence‐based practice and meeting the demands of professional accreditation requirements can mean that less time is available to teach the process elements of psychotherapy. The aim of this study was to conduct a preliminary evaluation of a clinical psychology psychotherapy training program that combines an interpersonal process group with a cognitive behavioural therapy training model that incorporates self‐reflection and self‐practice. Eleven participants who participated in the training in 2008 completed the Counseling Self‐Estimate Inventory at pre‐ and post‐training. Significant improvements on the majority of the subscales of this inventory were found. A separate sample of nine trainees and clinical psychology registrars who also previously completed the program attended individual interviews in 2010 aimed at gaining their perspective regarding various aspects of the program. Self‐practice of cognitive behavioural therapy techniques was found to be important in the identification and management of trainees’ own core beliefs, and to their appreciation of how challenging this process may be for clients. The interpersonal process group was described by participants as enhancing their competency as psychotherapists. Common themes included the experience of anxiety and a high level of emotion, and understanding how this experience might be similar for clients; increased self‐awareness; and increased competence in process issues. Many participants believed the process and content components of training were equally important to their development as psychotherapists.