Transference,relationship and the analyst as object: Findings from the North American Comparative Clinical Methods Working Party

Data from the North American Comparative Clinical Methods (CCM) Working Party a is used to 1) explore how psychoanalysts in North America conceive and address the transference and the relationship between analyst‐analysand and 2) to study what kinds of ‘objects’ psychoanalysts become, explicitly and implicitly, within psychoanalytic treatments. The North American CCM Working Party closely studied 17 clinical cases presented by North American psychoanalysts across the spectrum of analytic schools at their meetings. We found that the 17 analysts fell into three different groupings according to the internal consistency of their method and their approaches to transference, relationship and analyst‐as ‐object. We also found that analysts' individual work, while heavily influenced by their schools of thought, also involved unique interpretations of their particular paradigms.     

Les représentations mentales de l’enfant chez les parents : situation,illustrations et réflexions sur les catalyseurs de changements en évaluation thérapeutique de l’enfant

Therapeutic assessment of the child (TA-C) is a model of psychological assessment that allows for collaborative work with parents and child on their reasons for consultation, a collaboration that breaks away from a traditional double separation (parent/assessor, and assessor/therapist) in child assessment. This paper, grounded in a contemporary psychodynamic viewpoint, presents clinical illustrations to support a conceptualization of change processes in TA-C. It is argued that, in order to revitalize empathy in parents, work focusing on the parents’ mental representation of their child is central. We propose a hierarchy of assessment/therapeutic goals that allows for a better distinction between TA-C and standard assessment in work with children.     

Client crying in the context of family therapy: an exploratory study

This study explores the crying episodes of twenty‐eight clients treated at a family therapy service in a community centre. The crying episodes were associated with some significant elements: the time of appearance, the content and triggering factor, the interpersonal context of sessions and the emotions clients had for the therapist, as well as the therapy's outcome (end of treatment and the satisfaction of clients). Crying was much more frequent during the first session. It occurred more frequently when there was another family member present. The proportion of clients who cried during the treatment was significantly higher for clients who completed it successfully. Clients who cried perceived the therapist, in all cases, as a kind person who never got annoyed with them. Crying could be considered a type of behaviour that helps the therapist to create a safe context and foster the therapeutic alliance.     

Children’s mental health: Time to stop using psychiatric diagnosis

Hegemonic mental health service approaches stress the need for ‘accurate’ diagnosis in order to understand what the correct ‘treatment’ should be. I review the evidence on how far diagnosis in psychiatry has helped advance scientific knowledge and clinical practice and conclude that it hasn’t. I then examine how National Institute for Health and Care Excellence (NICE) guidelines in relation to children’s behaviour problems reflects the lack of progress that results from adopting a diagnostic approach. Taking mental health practice beyond reliance on narrow non-evidence-based diagnostic algorithms can be developed by adopting existing projects such as the Partners for Change Outcome Management Systems project.     

Psychotherapy and its alternatives: Commentary on a critique

In this commentary, Michael Rustin reviews the articles in the symposium, outlining their main aims and arguments. He goes on to provide some critical reflections, asking questions about the key concept of the ‘therapeutic state’. He notes that little attention is given to psychoanalytic or other psychological theories of the mind, as distinct from the biological models which are the main object of criticism in the symposium. He argues that just as it is justifiable and useful to take account of theories of the mind in considering issues of mental health and therapy, so it is desirable also to take account of the structures of society which have responsibility for generating conditions of mental well- or ill-being, and to reflect on how these may be changed. The commentary argues that the counter-cultural and somewhat ‘post-modern’ critical approach which informs the symposium can only form part of a sufficient response to the problems which the symposium identifies.     

But it still goes on: Therapeutic communities today

The work of therapeutic communities (TCs) have been said to develop from a certain ‘impulse’ or ‘attitude of mind’. The origin and definitional function of these terms are briefly traced and their meaning explored. Subsequently, eight papers submitted to the Journal are reviewed in order to give a survey picture of the theoretical and practical concerns current within European TCs. This brief survey demonstrates that, while rooted in the TC tradition, a number of projects have made interesting developments in both practice and theory. These innovations and the flare which has gone into them can be taken as evidence that the TC impulse is alive and well. What TCs require now are wider and more effective means of transmission to others because at their best TCs are self-regulating systems which can potentially obviate the harm caused by the deregulating systems of traditional health and social care.     

Therapists' positive emotions in‐session: Why they happen and what they are good for

Aim: The therapist's feelings play a remarkable role in contemporary models of psychotherapy. However, these models are biased towards negative feelings. The present study explores therapists' personal experience with positive emotion in‐session. Method: A grounded theory analysis was conducted of interviews with 26 Brazilian psychotherapists. Results: Clinicians derive positive affect from the client's input in treatment, from their own input, and from the personal relationship with the client. Therapist positive emotion adds to the material that can be worked on in‐session by providing interpersonal events in the relationship with the client. It can improve therapist input in treatment by increasing in‐session awareness, resourcefulness and daring and by cuing efforts for professional development. It enhances involvement in the relationship with the client by prompting compassion and closeness in the dyad. Its effects may spill over and contribute to the therapist's personal thriving. Discussion: These results are discussed in light of what positive psychology can add to current work on therapist effects in the treatment process.     

Examining the Effects of Incremental Case Presentation and Forecasting Outcomes on Case-Based Ethics Instruction

Case-based reasoning has long been used to facilitate instructional effectiveness. Although much remains to be known concerning the most beneficial way to present case material, recent literature suggests that simplifying case material is favorable. Accordingly, the current study manipulated two instructional techniques, incremental case presentation and forecasting outcomes, in a training environment in an attempt to better understand the utility of simplified versus complicated case presentation for learning. Findings suggest that pairing these two cognitively demanding techniques reduces satisfaction and detracts from the effectiveness of the learning approach. Implications regarding the use of instructional techniques in training programs are discussed.