Greed 1

Abstract

This paper discusses the supervisor's responsibility in addressing the vulnerability or wounds of the therapist. Supervisors have much to keep in mind as they conduct their work, not least the client for whose benefit supervision is deemed to be an essential aspect of good practice. Their responsibility towards the client often entails careful exploration of the experience of the counsellor, both through their counter-transferential response to the client and their own personal circumstances. The extent to which the supervisor has a mandate to discuss the psychological well-being, personal difficulties, or organizational conflicts of their supervisee depends on both contractual agreements and the working alliance. The need to recognize counter-transference responses is generic but when they highlight the internal conflicts of the counsellor, the supervisor must decide how far they can or should pursue the unravelling of such conflicts. Therapist difficulties (Schroder & Davis, 2004 Schröder, T. and Davis, J. 2004. Therapists' experience of difficulty in practice. Psychotherapy Research, 14: 328–345. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) provide a framework for understanding ways in which therapeutic practice is affected by the emotional response of the therapist.     

Assessment and Intervention with Black-White Multiracial Couples

SUMMARY

Effective therapy with Black-White multiracial couples begins with therapist work on self attitudes and with sensitive assessment of the ways racism and race may or may not be connected to a couple's problems. We suggest ways to begin to explore self attitudes and suggest basic assessment questions for work with Black-White couples. In addition, we point out important clinical issues that may come up for Black-White couples in the areas of social support/social network, parenting, and grief.     

Split Self Affairs and Their Treatment

SUMMARY

The Split Self Affair is a long-term serious relationship. The split being played out in the affair reflects an internal split between doing things “right” and the emotional self. Treatment for those involved centers on understanding the origins of the internal split and on reclaiming the neglected emotional self. Long term individual therapy is the treatment of choice, augmented by other modalities.     

Acceptance of Tinnitus: Validation of the Tinnitus Acceptance Questionnaire

Internet‐based interventions with therapist support have proven effective for treating a range of mental health conditions. This study examined whether frequency of therapist contact affected treatment outcomes. Fifty‐seven people with panic disorder (including 32 with agoraphobia) were randomly allocated to an 8‐week Internet‐based cognitive behavioural treatment intervention (Panic Online) with either frequent (three e‐mails per week) or infrequent (one e‐mail per week) support from a psychologist. Posttreatment, intention‐to‐treat analyses revealed that both treatments were effective at improving panic disorder and agoraphobia severity ratings, panic‐related cognitions, negative affect, and psychological and physical quality of life domains, with no differences between conditions. High end‐state functioning was achieved by 28.6% of the frequent and infrequent participants, respectively. Therapist alliance, treatment credibility, and satisfaction also did not differ between groups, despite significantly greater therapist time invested in the frequent contact condition. The results provide evidence that the effectiveness of Internet‐based mental health interventions may be independent of the frequency of therapist support and may, therefore, be more cost‐effective than previously reported.     

Theoretical Orientation and Therapists' Attitudes to Important Components of Therapy: A Study Based on the Valuable Elements in Psychotherapy Questionnaire

The authors describe the inception and subsequent testing of a questionnaire on attitudes regarding how psychotherapy ought to be pursued: the Valuable Elements in Psychotherapy Questionnaire (VEP-Q). A sample of 416 Swedish therapists (161 psychodynamic, 93 cognitive, 95 cognitive behavioral, and 67 integrative/eclectic) responded to the 17-item VEP-Q. A factor analysis of these items resulted in three subscales: PDT, CBT, and Common Factor, as validated by analyses of covariance. The internal consistency and test–retest reliability of the scales were excellent. In addition to theoretical orientation, variables such as gender and basic professional training influenced how respondents answered the VEP-Q. The authors conclude that the VEP-Q seems to be an appropriate instrument for describing similarities as well as differences among practitioners of various schools of psychotherapy.     

‘Coming out’ in therapy? Perceived risks and benefits of self‐disclosure of sexual orientation by gay and lesbian therapists to straight clients

Primary objective: The study's primary objective was to investigate the experiences of gay and lesbian therapists, when considering self‐disclosure of their sexual orientation to straight (i.e. heterosexual) clients. This qualitative study set out to ascertain the key factors gay therapists take into account when considering this decision and to explore the effects this self‐disclosure may have on themselves, their clients and their therapeutic relationships. Research design: The research design was based on the use of semi‐structured interviews, undertaken with a non‐random, purposive sample of counsellors and psychotherapists (n=8) in current practice. The rationale for this method was to aid exploration of therapists' experiences of the process of self‐disclosure. Methods and procedures: Inclusion criteria were for therapists who self‐identified as being gay or lesbian, and who were experienced in clinical work with straight clients. Transcribed data was analysed using inductive thematic analysis. Main outcomes and results: Some therapists reported being confident with self‐disclosure relating to their own sexual orientation. However, a common theme related to the reportedly high levels of anxiety and vulnerability, which therapists identified. Key themes emerged around: respondents' fears of client judgement; a need for therapist self‐protection; self‐awareness of the potential impact of their own fears and prejudices on the therapeutic relationship; and the potential relevance of internalised homophobia, as an overall constraining factor. Conclusions: Self‐disclosure of their sexual orientation to straight clients is constructed, in this initial survey, as being potentially problematic and risky for some gay therapists.     

Development and Validation of an Instrument for the Assessment of Dependency Among Bereaved Persons

Dependency among bereaved individuals has been hypothesized to be an important predictor of severe and enduring grief reactions. However, although there are a number of instruments that assess interpersonal dependency as a personality trait or style, no scales are available to assess bereavement-related dependency. Data from 170 widowed participants in a community-based longitudinal investigation, who had been bereaved for an average of 10.8 months, were used to investigate the reliability and validity of the Bereavement Dependency Scale (BDS), an instrument that was developed to assess dependency on the deceased among bereaved persons. Results indicated that the BDS demonstrated acceptable internal reliability and satisfactory convergent, discriminant, and construct validity. The BDS may be a clinically useful predictor of enduring and complicated grief reactions, major depressive disorder, and suicidality among recently bereaved individuals.     

The Reaction of the Youth in Israel to the Assassination of Prime Minister Yitzhak Rabin

The assassination of Israeli Prime Minister Yitzhak Rabin by a political assassin caused shock, disbelief, and deep grief to the Israeli people. Particularly prominent was the reaction of the youth, who gathered in large crowds, at the site of the murder and in other places, and engaged in various mourning behaviors of a ritual nature. This drew the attention of the media in Israel and around the world. A study of approximately 700 teenagers conducted after the assassination examined their emotional reactions, participation in ritualistic mourning activities, and assessments of the reasons for feeling shocked. In all areas, differences were found as a function of gender, and attitudes toward Rabin's peace policy. An attempt was made to explain the youth's behavior in terms of the formation of groups and group identity.     

Immunity and health after bereavement in relation to coping

Coping was examined as an intervening variable between the stressor of bereavement and its effects on subjective health and immunity in thirty-nine recently bereaved Norwegian women. Coping was defined as: "positive response outcome expectancies". Data were collected approximately one month after the death of the husband, and twelve months thereafter. Data collected were: expected coping success (self-scoring), subjective health (UHI), anxiety and depression (GWB), and immunoglobulins (IgA, IgM, IgG) with components (C3, C4). Statistics were: frequencies, paired t -test, ANOVA, and MANOVA. Permissions and confidentiality were in accordance with the Helsinki-declaration. Coping was found to be related strongly to health and to health changes. Few relations were found between immunity and health. Coping, health, and anxiety and depression formed a triangle of interrelations. It was concluded that coping defined as "positive response outcome expectancies" may be a predictor of the adaptational outcome after a crisis.     

Maternal Identity Among Motherless Mothers and Psychological Symptoms in Their Firstborn Children

A variety of detrimental effects are associated with early parental loss. We examined the relationship between childhood maternal loss and maternal identity among 30 motherless mothers and their 26 matched controls, as well as the psychological health of their firstborns. Motherless mothers reported significantly lower maternal identity. However, firstborns of motherless mothers were no more likely to display psychological symptoms than firstborns of comparison mothers. The findings suggest that early maternal loss may not present risk for cross-generational effects.