The Relationship of the Self of the Therapist to Therapy Process and Outcome: are Some Questions Better Left Unanswered?

Gurman (1987) has challenged the field of marital and family therapy to answer questions concerning the relationship of the therapist to outcome. An examination of conceptual and empirical literature regarding the relationship of the self of the therapist to process and outcome in marital and family therapy discloses that empirical evidence for such relationship is not persuasive. The author constructs a crucible for the field of marital and family therapy.     

Ethical Considerations in Psychotherapeutic Systems

Theoretical Medicine and Bioethics - In the process of individual psychotherapy, the client and the therapist work together towards clarifying the client's problems, unlocking vicious circles,...     

Counselor performance in treating anxiety and depressive symptoms in integrated care: A client outcomes study

Depression and anxiety are two of the most common mental disorders treated in Integrated Primary and Behavioral Healthcare programs. We investigated the within and between performance differences of mental health counselors on anxiety and depressive symptomatology in an integrated service with a sample of 1573 clients and 10 licensed professional counselors. The results of growth curves within the framework of Multilevel Modeling showed significant within and between performance differences among counselors treating anxiety and depressive symptoms. Some counselors performed better in treating anxiety symptoms while others did better treating depression. Implications for counselor education, client care, and legislation are provided.     

Psychotherapists’ psychological well-being: The role of epistemic orientation and emotion regulation

Psychotherapists’ mental health has been traditionally associated with the harmful consequences of clinical practice. In contrast to this dominant model, a growing body of research in positive psychology has sparked an interest in therapists’ positive well-being. The main objective of this study was to examine the relations between therapists’ epistemic orientation modes, emotion regulation strategies and psychological well-being (PWB). This was a cross-sectional study in which participants were 674 therapists (78.5% women), with a mean age of 42.02 years (SD = 13.06). Therapists completed an online questionnaire containing self-report measures of all study variables. Structural equation modelling using latent variables was performed to test the study hypotheses. Results revealed no significant direct effects of epistemic orientation on PWB. Up- and downregulation strategies had the most substantial direct effects on total PWB. Furthermore, emotion regulation mediated the association between therapists’ epistemic orientation modes and PWB, accounting for 57% of the variance in the outcome variable. Implications for training, practice and therapist self-care are discussed.     

The desirability of beliefs: preschoolers' appreciation of fact beliefs and subsequent emotions

In this study, we investigated the extent to which preschool children's own knowledge about reality biases their understanding that others' beliefs about reality govern others' emotions and not reality itself. Therefore, an increasing tension was created between the beliefs of the protagonist and the participant, by providing varying degrees of evidence about the validity of the protagonist's belief. Children of between 4 and 5 years of age were asked to predict the protagonist's emotion, given the protagonist's desire and the protagonist's belief. The results show that, to a certain extent, preschool children take others' beliefs into account when predicting others' emotions. When the outcome is clear, children probably feel tied to reality, and in the case of false beliefs, their knowledge about reality biases their emotion predictions, as was also evident in ‘false belief’ research (Wimmer H, Perner I. 1983. Beliefs about beliefs: representation and constraining function of wrong beliefs in young children's understanding of deception. Cognition 13: 103–128). However, when it is uncertain what the actual outcome will be, then it is not the likelihood of others' beliefs but the desirability of the outcome that biases children's predictions of others' emotions. In other words, when the actual outcome is yet unclear, 4‐ and 5‐year‐olds show a tendency for wishful thinking in their predictions of others' emotions. Copyright © 2000 John Wiley & Sons, Ltd.     

The Relationship Between Client Emotional Expressions, Therapist Interventions, and the Working Alliance: An Exploration of Eight Emotional Expression Events

The relationship between client emotional expression and therapist interventions was studied in two working alliance conditions. An events-focused methodology was used to examine a total of 8 events taken from a variety of therapeutic orientations. Results indicated that, in the presence of a good client–therapist relationship, therapists showed higher levels of empathy and effectively focused on the immediately expressed feelings; in turn, their clients were engaged in exploration of feelings. In poor-relationship dyads, clients expressed negative feelings toward the therapists. Interventions rated as effective by clinical judges were characterized by accurate therapist understanding of clients' emotional expressions and working with strains in the therapeutic relationship. Ineffective interventions were associated with inaccurate assessments of clients' emotional states. Intensive analysis of these sessions led to three distinct models of in-session emotional expression events. Theoretical and practical implications of these models will be discussed.     

What Game Is Being Played? The Need for Clarity about the Relationships Between Scientific and Theological Understanding

This paper investigates the relationship between theology and the natural sciences by considering four realist and five nonrealist interpretations of theological understanding. These are that theology expresses biblical affirmations, the faith of the community, revelatory declarations, or a prioriconclusions, and that it is reducible to expressions of feelings, attitudes, naturalism, liberating praxis, or moral convictions. Because these views are unsatisfactory, the author calls for an imaginative form of natural theology that shows how faith's understanding of the purpose, value, and meaning of reality fits how the world is actually found to be.     

Finding focus in a difficult landscape: Therapists’ experiences with challenging video guidance processes for parent–infant dyads

Marte Meo video guidance uses filmed interaction of the actual parent–infant dyad in the guidance of caregivers. Exploring the challenges that therapists meet in the guidance of parent–infant dyads may illuminate important aspects of the method itself as well as the therapists’ role and requirements. This could lead to method development and improved practice, but is hitherto little addressed. In this paper, we explore how skilled therapists experience and handle challenging or failing guidance processes with parent–infant dyads. We analyzed interviews with 13 Marte Meo therapists/supervisors using team-based reflexive thematic analysis. Four main themes were identified: promoting relational growth in a coercive context, building an alliance that feels safe for the parents, looking at positive moments in difficult lives, and handling intense feelings as a therapist. Our findings show that therapists experience specific therapeutic and ethical challenges with a vulnerable subgroup of parent–infant dyads where child protective issues arise, where caregivers’ insecurities impede the therapeutic relationship, and where caregivers have unsolved relational or mental health problems. The therapists’ role becomes pivotal and demanding with regard to the therapeutic alliance, the therapeutic interventions in the guidance process, and their own need for regulation, supervision, and structure. Identification of these vulnerable dyads early in the process could facilitate a better adaptation and practice of video guidance. Our findings suggest a need for supporting structures, clinical supervision, and training that address these challenges.