Therapists’ perspectives about working with meaning in life in psychotherapy: A survey

Of 212 practicing therapists who completed a survey about working with meaning in life (MIL) in psychotherapy, 129 (61%) had recently worked with MIL with at least one client and reported on their work with a client in this survey. Those therapists who had worked with a client on MIL as compared with those who had not were older, more experienced, more humanistic/existential/experiential in orientation; reported more MIL training; and felt more competent working with MIL. Clients reported on primarily had internalizing, interpersonal, and career issues. Only 12% of clients explicitly labeled MIL as an issue coming into therapy. The three most frequently used interventions involved offering support; helping clients examine thoughts, feelings, and behaviors to discover hopes and goals; and facilitating exploration of MIL cognitions and experiences. Therapists reported many positive consequences from working with MIL. Therapists reported minimal training in MIL and moderate competence in working with MIL. Implications for practice, training, and research are presented.     

Teaching mindfulness to psychotherapists in clinical practice: The Mindful Therapy Programme

Introduction: Initially proposed as a treatment modality for psychological disorders, mindfulness is now being promoted as a means of enhancing both therapist self care and therapeutic efficacy. The degree to which mindfulness can be learned by therapists to manage their own and clients' processes in therapy is as yet unknown. This study examines training outcomes of a standardised introductory mindfulness programme for mental health professionals. Methods: Forty-seven mental health professionals completed an eight-week mindful therapy (MT) training programme and associated measures. Results: Compared with baseline scores, participants demonstrated knowledge acquisition on all measures, including increased mindfulness in clinical work, increased capacity to intentionally invoke mindful states of consciousness, and higher participant ratings of well-being over the course of training sessions. Discussion: This research provides preliminary evidence that a brief, standardised mindfulness training programme can achieve acceptable knowledge and skills outcomes for therapists that can aid their therapeutic practice. Of note, increased ‘therapeutic mindfulness’ in this study resulted from changed mindfulness ‘attitudes’ (i.e. a more accepting and equanimous orientation within therapeutic work) as opposed to a clear demonstration of increased attention-regulation skills. The implications of these and other results for programme development and wider research are discussed.     

自觉作“研究型”的临床医学家——幽门螺杆菌研究获奖的启迪

沃伦和马歇尔关于发现幽门螺杆菌的出色研究,为临床医师们提供了一个值得学习、借鉴的宝贵案例。他们经历平凡,研究执着;打破教条,挑战权威;面对抵制,甘耐寂寞;争取支持,善于合作……体现了从事临床医学研究所必须具备的学术品质。临床医师们应该以他们为榜样,自觉作“研究型”的临床医学家。     

Use of the Group Therapist's Personality Via the Countertransferences

Rather than use the term therapist personality, the author uses an operational definition of countertransference to examine the intersubjective field between group therapist and individual patients, the group, and subgroups. Differentiating between objective and subjective countertransferences, the author traces their sources to the transferences and resistances that arise from individuals, subgroups, and the group-as-a-whole. The transferences, resistances, and their related countertransferences are then integrated with enactments and history to create interventions. The charismatic leader makes no differentiation between the countertransferences and primarily acts on impulse or a rigid system.     

Pragmatism, Pluralism, and Psychotherapy Relationships: An Interview with John C. Norcross, Ph.D.

John C. Norcross has made significant contributions in the areas of the transtheoretical model of change, psychotherapy integration, and empirically supported psychotherapy relationships. This interview explores the contributions of pragmatic philosophy and his personal upbringing to his work as a psychotherapy researcher and practitioner. Dr. Norcross discusses the status of the psychotherapy integration movement, the work of the Task Force on Empirically Supported Psychotherapy Relationships, and future trends in psychotherapy over the next 25 years. He emphasizes the importance of a methodological rigor that recognizes the unique characteristics of the psychotherapy relationship. He describes his current interest in the psychotherapy of psychotherapists, illustrating it with his personal challenges in balancing work and home.     

Experiential Tasks and Therapist Bias Awareness

All therapists have values, assumptions, and beliefs about groups of people who are different from the dominant culture. How the therapeutic process is shadowed by therapists' assumptions and attitudes toward ethnic minorities is discussed. The author provides experiential techniques such as visualization, role playing, role reversal, family sculpturing, and a written assignment as a vehicle to heighten a family therapists' awareness of underlying assumptions and biases toward clients of an ethnic minority.     

GENERALIZATION EFFECTS FROM INTRATHERAPY ARTICULATION TRAINING: A CASE STUDY1

This study analyzed generalization effects found associated with a language-training intervention to modify the articulation (/f/ phoneme) of a 3.5-year-old boy. The McLean and Raymore Stimulus Shift Articulation Program was implemented by the subject's mother. This language training program is designed to produce setting generalization effects based on an intratherapy training model (i.e., systematic training is applied in a single setting to promote transfer effects to nontraining environments). The intervention resulted in a significant improvement in the subject's production of the /f/ phoneme within the clinical setting in response to untrained stimuli (stimulus generalization). Additionally, the subject's correct phoneme production was observed to generalize to his home and school settings (setting generalization) under “opportunity loaded” (picture prompts) and “spontaneous” (no prompts) conditions. The results provide case-study evidence that stimulus generalization, both within and across settings, may occur with exclusively intratherapy articulation training.     

Therapist attitudes and countertransference as predictors of professional quality of life and burnout among psychotherapists

This study aimed to examine the role of attitudes towards psychotherapy and countertransference dimensions as predictors of professional quality of life and burnout among psychotherapists in Iran. Participants were 259 psychotherapists who worked in mental health centres in Tehran (Iran), and they completed the Professional Quality of Life questionnaire, the Therapist Response Questionnaire and the Therapist Attitudes Scale. Professional quality of life was associated with countertransference dimensions and attitude towards psychotherapy. This study concludes that psychotherapists can benefit from working on their specific countertransference issues and re-evaluating their basic attitudes towards psychotherapy to achieve the highest levels of professional satisfaction. Culture may play a role in a specific therapist's attitude and difficulties in addressing certain aspects of countertransference.     

Vocal indicators of facilitative interpersonal skills

The facilitative interpersonal skills (FIS) method uses simulations of difficult client moments as a test of helpers' ability to remain therapeutic in therapeutically stressful situations. A total of 135 participants completed the FIS task as part of a training in helping skills and provided verbal responses that were assessed by trained raters for interpersonal skills. Audio recordings of these verbal responses were then analysed acoustically for fundamental frequency (F0), spectral slope and F0 range. Mean F0 and F0 range were more highly associated with trained raters' ratings of FIS for female participants than for male participants, although F0 range was associated with FIS of both males and females. The results suggest that F0 is associated with FIS for females, especially the FIS items that are indicative of emotional expression and verbal fluency. Findings are discussed as possibly indicating that some expression of higher F0 in response to distressed client situations may be part of interpersonal skills, such that more skilled therapists respond to stressful client situations with a higher F0.     

The variability of client,therapist and clinic in psychotherapy outcomes: A three-level hierarchical model

This article investigates the percentage of variance in psychotherapy outcomes explained by the case-mix variables for individual cases, by the therapist (therapist effects), and what additional variance is explained by the clinic with which the therapist is affiliated. While there has been substantial recent research regarding therapist effects, very little has been published regarding clinic-level effects after controlling for therapist effects. The study utilised the largest sample reported to date, using data from 28 clinics with a minimum of 2,000 cases in a clinical range of severity of symptoms with pre-post change scores on an outcome questionnaire. Only cases treated by a therapist with at least 30 cases were included. These selection criteria resulted in a case count of 156,258 clients treated by 874 therapists located at 28 clinics. After controlling for differences in case mix using diagnosis and intake score (severity of symptoms), the resulting analyses indicated that 5.21% of the variance in treatment outcome was explained by the therapist, while another 1.13% of the variance was associated with the clinic. Findings are discussed with implications for practice and policy.