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This study examined the constellation of interaction structures – repetitive patterns of interactions between patient and therapist over the course of treatment – that emerged in the psychodynamic therapy (PDT) of a child diagnosed with borderline personality disorder and treated by two doctoral student therapists. Identification of these interaction structures can inform therapists of what might be expected from patients with particular symptom or behaviour patterns and how interactions change over time. This study also examined each session’s adherence to three session prototypes: PDT, cognitive-behavioural therapy (CBT) and reflective functioning (RF) process. The Child Psychotherapy Q-Set (CPQ) is a 100-item instrument that assesses the processes within a single psychotherapy session. Items reflect a wide range of therapist attitudes and behaviours, patient attitudes and behaviours and interactions between therapist and patient. Experts used the CPQ to define PDT, CBT and RF process session prototypes. The results suggested that four distinct interaction structures could be identified and that their constellations differed between the two therapists and also differed over time within each treatment. Therapists were more structured and accommodating early on in their treatments and more interpretive later. Prototypical PDT process was more prominent in the sessions than RF process, which in turn was more prominent than CBT process. Unique therapeutic processes are at work in every dyad, despite holding the patient and theoretical orientation constant. An effective treatment in one dyad might not work in another due to therapist-specific and dyad-specific effects.  相似文献   
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When a child is offered psychotherapy, it is common that regular meetings will be offered to the parents. However, there are debates in the literature about the degree to which such parent work should include a focus on the parents’ own childhood experiences. This study aimed to examine the way that those offering parent work as part of a study evaluating the treatment of adolescent depression dealt with this issue in their work with parents, both in the study and in routine clinical practice. Design: five therapists were interviewed on the subject of working with parents’ childhood experiences within parent work parallel to child psychotherapy. Data were analysed qualitatively, using Interpretative Phenomenological Analysis. Findings: participants described the need to consider the different parameters of this work to individual adult therapy; in addition, participants felt that it was necessary to negotiate permission to work on the parents’ childhood experiences. They also spoke of making use of insight into the repetition of the parents’ history, the analysis of parental projections and offering containment within the relationship; this varies from the ‘transference work’ of individual therapy and a different style of interpretation was described. Conclusions: there is a need to give more attention to the neglected field of working with parents alongside individual child psychotherapy, especially at a time when such work is under threat within many public services. There are particular technical issues related to work with parents’ own childhood histories that are different to how one might work in individual therapy with a parent.  相似文献   
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The experiences of disabled people suggest that ableism insidiously and invasively impacts upon the practice of counselling and related therapies. This article critiques a particular account of psychotherapy with a child with the label of autism to illustrate how ableism can disrupt the process of empathy and negate the therapeutic experience. In so doing the article highlights the inherent difficulties in traversing different epistemic positions to make sufficiently informed readings of counternormative expressions of being. General principles of counselling practice are then proposed to support practitioners with providing effective therapy for all clients.  相似文献   
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Introduction: The purpose of this study was to examine questions related to the process, perceived outcomes, and ethics of therapists who provide counselling and therapy online. Method: An online survey was conducted (N=93) with identified e-counsellors with at least a Master's Degree. Questions included demographic information and Likert-type scales related to extent of practice, theoretical orientation, training and supervision, attitudes about appropriate practice, referral, legal and ethical issues, practice difficulties, and therapist satisfaction. Results: Overall, e-counsellors are satisfied with their practice and believe it is effective. They generally do not have formal training or supervision in online practice. Current e-counselling appears to be a part-time, supplemental practice with little overlap to FTF practice. There was little agreement among respondents on attitudes, practice, ethical issues, and knowledge of regulations related to e-counselling. Discussion: Lack of consensus about ethical obligations and practice suggest the need for formal training in e-counselling by professional programmes and international cooperation in formulating practice ethics. Areas for further research are discussed.  相似文献   
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Positive psychotherapy (PPT) is a therapeutic approach broadly based on the principles of positive psychology. Rooted in Chris Peterson’s groundbreaking work on character strengths, PPT integrates symptoms with strengths, resources with risks, weaknesses with values, and hopes with regrets in order to understand the inherent complexities of human experiences in a way that is more balanced than the traditional deficit-oriented approach to psychotherapy. This paper makes the case of an alternative approach to psychotherapy that pays equal attention and effort to negatives and positives. It discusses PPT’s assumptions and describes in detail how PPT exercises work in clinical settings. The paper summarizes results of pilot studies using this approach, discusses caveats in conducting PPT, and suggests potential directions.  相似文献   
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