Who,What, When,Where, How,and Mostly Why?

SUMMARY

The death of a client by suicide was very emotionally destabilizing to this therapist. She worked hard to distance herself personally from the pain at first and at the same time she found herself overfocused on the “psychological autopsy.” She had difficulty accepting new clients and wanted to withdraw from a meaningful appointment to a state advisory committee. Only when she was able to identify with the client's pain and realize how that pain touched her own history of loss was she able to grieve productively. She realized that gender was relevant in her identification with the victim and in sorting out each of their histories of loss.     

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.     

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.     

Does theoretical background influence therapists' attitudes to therapist self‐disclosure? A qualitative study

Aims: This study investigated therapists' attitudes towards therapist self‐disclosure over different theoretical orientations and to establish how classical theoretical background and training effected and informed practice. Classical theoretical background was intended to refer to traditional Psychodynamic understanding. Method: Participants were experienced therapists drawn from four groups by a recruitment screening measure. Three groups were from the students’ cohort within a university Masters programme in Psychological Therapies. Participants were practicing from CBT, Systemic and Psychodynamic orientations. A further group was drawn from Person‐Centred therapist/trainers at a further education College. Data was gathered using focus groups and analysed using thematic analysis. Findings: Three major and one lesser theme emerged. These revealed that there was a spectrum of willingness to disclose throughout all groups, classical training influenced all participants; total restriction of TSD was impracticable and attitudes were affected by concerns for the therapeutic relationship. Implications for practice: TSD needs to be more thoroughly explored within therapy training and supervision. A structured framework could help inform practice. Conclusions: The study supported the idea that Classical Training influenced TSD.     

Therapists’ understandings and experiences of working with clients with problems of addiction: A pilot study using Q methodology

This pilot study aims to increase our understanding of therapists’ subjective attitudes, beliefs, and experiences of working with clients with problems of addiction. The study yielded useful clarifications, arising from the finding that opinions about the nature of addiction support different approaches to therapy. In addition, it seems that diverse or conflicting attitudes and beliefs are likely to impact on the ability of therapists to work together effectively. Another objective was to test the feasibility of using Q methodology in this study and more broadly in qualitative research in psychotherapy. Participants were 13 therapists from a variety of backgrounds and working in a range of agencies. Using Q methodology, four distinctive factors were identified, indicating divergent understandings of addiction. Each factor is shown to be a multifaceted construct which does not correspond to any single theory or therapeutic orientation. It is suggested that the results have significant implications for therapists’ training and supervision. In addition, this study demonstrates the capacity of Q methodology to identify commonalities and diversity in viewpoints which do not conform to a priori conceptualisations. As a pilot study, this paper invites further discussion and research.     

A Developmental Perspective of Marriage and Family Therapist's Ethical Principles: Support for the Practitioner–Ethics Relationship Model

This study explored therapists' professional ethics by assessing therapist at-risk behaviors as they relate to ethical proficiency in the field of Marriage and Family Therapy. A survey assessing practice behaviors was distributed among marriage and family therapists (MFTs) of varying levels of experience. Data gathered were analyzed using factor analysis, structural equation modeling, and multiple regression. Results indicate a positive relationship between the latent variables of risk and justification, as well as a significant relationship between these variables and years of clinical experience. Findings provide evidence to support the practitioner–ethics relationship model proposed by the authors. Implications of these findings, as well as future directions for research and policy are suggested.