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Writing psychodynamically oriented clinical papers is a daunting yet important task. To understand the page-by-page challenges better, I interviewed 12 editors of 4 clinically oriented American social work journals. This paper grew out of that project. It briefly describes the peer review process and examines how editors serve as both gatekeepers and mentors. It then describes how they interpret journal guidelines for evaluating manuscripts, how they spot potential in problematic manuscripts, view a manuscript's conceptual strength, define clinical data, think about the question of "proof," and identify contributions social workers can make by writing about their clinical work. [ABSTRACT FROM AUTHOR]

Children who have been removed from their homes as a result of maltreatment and abuse and have been placed in foster care or are in the process of adoption often continue to meet their birth parents by court decision. This contact is often held under supervision. Supervised contact is intended to provide children the opportunity to maintain the parent-child relationship in a safe and neutral setting. Findings have shown that in some cases supervised contact can be harmful, undermining the children's sense of security and placement stability. It has been suggested that agencies have limited practice skills to help build constructive relationships through contact visits, and may thereby be failing to offer sufficient support for supervised contact. While the literature highlights various aspects that need to be implemented to improve visits, there is a lack of a trauma-informed approach, whereby professionals supervising visits can address the traumatic experiences that led to the circumstances of supervised visitation and respond to the difficult emotions of all those involved. This paper provides practice guidelines for professionals accompanying supervised visits using principles of Child-Parent Psychotherapy, a trauma-informed dyadic intervention model for young children. Case vignettes illustrate how professionals supervising contact might address the child's trauma history and help birth parents and foster/adoptive parents respond to the child's attachment needs following trauma, and how professionals can support birth parents and foster/adoptive parents, thereby promoting safety and improving child-parent interactions. Recommendations are offered for attaining the best clinical practices in supervised contact, using seven practical guidelines. [ABSTRACT FROM AUTHOR]

The pervasive impact of trauma across populations and stages of life has made it imperative that the field of social work remain at the forefront of trauma-informed theory, research, and practice. The limited, adjunctive use of 3,4-methylenedioxymethamphetamine (MDMA) in the psychotherapeutic treatment of posttraumatic stress disorder (PTSD) is a promising new treatment model that has shown impressive efficacy in phase I and II clinical trials. Preliminary meta-analysis suggests that MDMA-assisted psychotherapy (MDMA-PT) may be superior to prolonged exposure, a first-line treatment for PTSD, and the U.S. Food and Drug Administration (FDA) has granted the treatment "breakthrough therapy" designation, a process of expedited review which signals that a treatment may demonstrate substantial improvement over existing therapies. Though these results are encouraging, much remains unknown and it is essential that the field of social work become informed and engaged in this new body of research. This paper will review the existing literature on MDMA-PT for PTSD, examine ethical and safety concerns, present a preliminary conceptualization of MDMA-PT's impact on the therapeutic process, and discuss implications for future social work research and practice. This paper finds that the current literature suggests that MDMA-PT is a safe and efficacious treatment that has the potential to revolutionize the treatment of trauma. At the same time, issues of safety, cost, and accessibility should be examined in depth to ensure that this treatment—if approved by the FDA—is accessible to racially and economically marginalized clients. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented in which the author discusses an article on attachment by Crayton Rowe, an article on the reintegration of veterans by Martha Bragin, and an article on neurobiology by Diane Barth.

Animal-assisted therapy (AAT) is considered an effective treatment model to use with a variety of populations and conditions, from autism to substance abuse, due to its flexible nature. As an integrative model, it often incorporates core modalities such as psychodynamic psychotherapy, cognitive behavioral therapy, psychodynamic psychotherapy and Gestalt therapy. Although there is a growing body of research addressing the efficacy of AAT, there is limited information on the actual process of utilizing AAT in clinical social work practice. Research shows that many clinicians support the use of AAT with clients but fail to integrate it into their own practice due to a lack of knowledge on the process of utilizing the model. This paper explores the process of integrating AAT into direct clinical practice and the theoretical basis for utilizing AAT as an adjunctive treatment model. [ABSTRACT FROM AUTHOR]

This paper presents ideas for understanding the self that is responsive to contemporary trends in professional practice. In addition to psychosocial factors, which have been associated historically with the practice of clinical social work, the paper integrates neurobiological factors into the discussion. The intent of the paper is to offer practitioners a conceptual framework for thinking biopsychosocially about clients. The framework underscores diagnostic understanding as the basis for the choice of specific interventive modes and techniques, and the centrality of a therapeutic relationship as the vehicle through which a new sense of self may emerge for clients. [ABSTRACT FROM AUTHOR]

Discussions pertaining to culture, power and/or identity frequently create tensions that are enacted by dyads and groups within schools, workplaces and communities. Although tensions can easily escalate into conflict or violence, we have observed that these tensions can serve as prompts that promote a change process. When individual perspectives are challenged, some participants are able to dissemble their views and consider other perspectives from which new understandings and views emerge. At times, when groups seem to be on the threshold of overt conflict, some participants engage in processes that examine the tension, explore new possibilities, and alter the view of one’s subjectivity. We suggest that these activities occur as momentary states in psychological spaces conceptualized as third spaces (Bhabha, The location of culture. London: Routledge, 1994). In this paper, we use concepts from psychodynamic and social theories to describe the conditions that coalesce to form states of mind (nepantla) (Anzaldúa, Borderlands/La Frontera: The new mestiza. San Francisco: Aunt Lute Books, 1999; Interviews Entrevistas. New York: Routledge, 2000) and the ability to engage in new relational possibilities (third space activities) with dyads and groups, outside of psychotherapy. The conditions include: critical consciousness, regulation, recognition, and responsibility. We then describe how such momentary experiences can subsequently result in an examination of one’s subjectivity, particularly as it pertains to issues regarding culture, power, and identity. Throughout the paper we provide four examples from various settings to illustrate these concepts and processes. Given the increasing racial/ethnic diversity of clients and clinical social workers in North America, this concept of third spaces holds particular relevance for contemporary clinical social work practice. [ABSTRACT FROM AUTHOR]

Treatments for women with obesity, depression, and body image concerns are not optimal. Weight loss programs lead to long-term weight gain for most participants, and even successful participants typically sustain only modest weight loss. Psychotherapy for depression is more effective, but as many as 50 % do not fully remit. When depression and obesity co-occur in women, outcomes are even more modest. Innovative treatments are needed to enhance the physical and mental health of obese, depressed women. The goal of the current paper is to describe the development of a treatment that integrates two innovative approaches for mental and physical self-acceptance. The Health at Every Size (HAES) paradigm, used to enhance physical health without encouraging weight loss, causes improvements in physical health among overweight participants that are longer-lasting than weight loss programs. Acceptance and Commitment Therapy (ACT) focuses on valued life behaviors and acceptance of painful emotions. ACT is efficacious for depression and as an adjunct to obesity treatment, and may be more effective for treatment-resistant depression than standard approaches. An integrated HAES/ACT treatment, known as Accept Yourself! and its manual is described in this paper, with information about how we adapted HAES and ACT approaches to create the intervention, as well as clinical strategies for implementation. [ABSTRACT FROM AUTHOR]

This paper explores two sides of the coin with respect to the topic of the aging therapist in clinical practice: a diminution of health resulting in an inability to recognize the need to retire and a choice to retire while in good health to pursue other ways of living. It is my position that some distinguished practitioners of psychoanalysis and psychoanalytic therapy, for a myriad of complicated reasons, are unable to deal with the diminution of their faculties-a symptom of dementia-that renders them incapable of making a critical assessment as to whether they should continue to practice. Using material gathered from interviews, I attempt to ascertain why clinicians are leery of open discussion of these issues. In a field where self-examination is paramount, why are therapists reticent to acknowledge the reality of cognitive impairment as a factor in functionality, before it occurs? In addition, can therapists embrace, without negative attribution, other therapists' choice to retire in good health-at the 'top of their game'-in order to pursue other important developmental milestones, which lay outside the practice of psychotherapy? [ABSTRACT FROM AUTHOR]

The article presents the author's views on a paper by Professor Herbert Strean which focuses on psychodynamic therapy. According to the author, the paper is simplistic and poorly researched, and that at times it shows the very dehumanizing tendencies it decries. The author particularly remarks on the homosexual and other, presumably deviant, life styles and to his implication that patients who do not choose long-term treatment. Moreover, the author was particularly interested in the section about short-term therapy, citing that Strean dismisses brief therapy and seems to be ignorant about its developments.

This article presents summaries of papers presented at a panel discussion on the comparative theoretical and treatment advances in child and adult psychoanalysis. Katherine Rees' paper was titled Cognitive Dimensions in Technique. At the outset Rees advanced her central theme of the importance of increased inquiry and knowledge of the development of normal cognitive capacities and processes, a common ground for child and adult analysts. Dale R. Meers' paper was titled Ego Psychological: Defenses, Regression and Revolution. Meers proceeded to highlight the history of ego psychology with particular focus on Anna Freud's contribution to theory construction. Steven Marans' paper was titled Play and Talk. He stated the goals of child and adult psychotherapy are similar: understanding the inner workings of the mind and their influences on daily life, making what is unconscious conscious in an attempt to widen the range of personal adaptations. Carla J. Elliott-Neely's paper was titled "The Process of Working Through in Child Analysis. She highlighted Freud's development of the concept working through. Freud observed that the adult patients required time to assimilate the insight gained from the interpreted resistances. Elliott-Neely noted Freud's linking working through to the repetition compulsion and the emphasis he placed on the concept as a means of conflict resolution and psychic change.

This paper discusses child abuse as an existential crisis. It describes existential counseling as an approach to helping abusive parents to become more responsible and better able to cope with this particular crisis of their existence. Three types of crises are identified: developmental or maturational, acute, and chronic. Each appears receptive to existential counseling within a framework of crisis intervention. Themes and the basic philosophy of existentialism are discussed. A case example provides an illustration of existential counseling in child abuse. Suffering is viewed as a dynamic concept within the framework of the existential psychotherapy of Victor Frankl, called Logotherapy, which is the primary one employed in this paper. [ABSTRACT FROM AUTHOR]

This paper draws largely upon the developmental theory of Margaret Mahler. It depicts a seemingly regressive revisitation of disturbed older male adolescents in transitional residential programs to unresolved elements of the original rapprochement crisis in the separation-individuation process. It describes how cycles of intense shadowing and darting behavior reemerge as the possibility of authentic independent functioning beckons. There is presentation of the way in which this revisitation, including splitting phenomena, is manifested in the residential treatment environment. Therapeutic implications are focused upon. A practice vignette illuminates the metapsychological thrust of the paper. [ABSTRACT FROM AUTHOR]

The aim of this paper is to facilitate the clinician's ability to perceive metaphoric meaning within the context of a patient's verbal discourse. The importance of verbal communication is noted followed by three comparative definitions of the metaphor. Psychoanalytic literature dealing with possible unconscious significance of the metaphor as well as recommendations regarding its utilization as an interventive strategy are reviewed, illustrative case vignettes are presented and possible symbolic meanings are discussed. Finally, implications for working with the metaphor in the context of clinical practice, considering a variety of interacting variables, are explored. [ABSTRACT FROM AUTHOR]

As emotional beings in a physical body, human consciousness and perception are bombarded with information from within and without. Information comes from the body's sensory systems, which helps a human know if a situation is safe or not safe, pleasurable or painful, with which to engage or to avoid. As situations become common, the body lessens the response in deference to new situations. The push and pull of neural focus impacts perception, behavior, and emotions. This paper uses sensory integration theory to examine a psychotherapeutic case study and make connections to perceptions and worldview that stem from the body responses to the environment. Sensory systems are explained in the context of the lived experience of an adult and his reflection on childhood. This case study sheds light on the maladaptive behaviors that may arise from misperceptions and suggests a therapeutic approach that uses the connection of mind and body to build rapport, work through client resistance, and ultimately bring subconscious body processes that impact perception into consciousness. [ABSTRACT FROM AUTHOR]

Current research reveals that trauma often cannot be resolved solely through interventions that utilize left-brain functions, such as those used in traditional talk therapy. Because trauma is actually something that happens deep in the core of the brain and the body, the most effective treatment approaches integrate traditional therapy modalities with those that focus on calming the nervous system such as yoga, mindfulness, imagery, expressive arts, and eye movement desensitization and reprocessing. This paper will focus on synthesizing current information on traumatic stress, the neurobiology of trauma, and evidence-based, body-integrative interventions provided within the framework of the Collaborative Change Model (CCM) (Barrett in The systemic treatment of incest. Taylor & Francis, Bristol, ; Treating complex trauma: a relational blueprint for collaboration and change. Rutledge, New York, ). Through the framework of the CCM, this paper will provide clinicians with an understanding of how and when to engage clients in body-mind approaches, how to help clients learn to recognize when they are in fight, flight, or freeze response patterns, and how to develop skills for managing emotional dysregulation. A detailed case study will be provided to illustrate this integrative approach in the treatment of trauma. [ABSTRACT FROM AUTHOR]

This paper explores the application of nonlinear dynamic systems theory and concepts to the investigation of the psychotherapeutic situation. Although dynamic systems theory was originally applied in the study of chemistry, mathematics, and physics-not initially for its application to psychotherapy-its emphasis on contextualization provides a rich platform for the reconsideration of how change occurs in the therapeutic dyad. This paper first reviews some tenets of dynamic systems theory, in particular the general processes of system change including the introduction of novelty and perturbation. It then examines some psychoanalytic theories from a dynamic systems vantage point. This is followed by the presentation of two cases that illustrate the application of systems concepts to clinical work. This paper concludes that psychoanalytic psychotherapy from the perspective of dynamic systems theory views moments of change as unpredictable, soft assembled, and emergent in the dialogue and context created mutually by therapist and patient. [ABSTRACT FROM AUTHOR]

A growing body of psychoanalytic literature recognizes that dynamic therapy can be transformative for therapists as well as for patients. Relational concepts such as co-construction and mutual regulation highlight interactive processes that facilitate bidirectional change. This paper summarizes the theoretical rationale for mutual transformation, presents a detailed case study illustrating how transformation evolves, and concludes with a brief commentary written by the patient. [ABSTRACT FROM AUTHOR]

Increasingly clinical work has explored the value of disclosure, particularly personal disclosure, in the therapeutic process. This new found freedom to reveal has also raised alarm amongst some clinicians. This paper explores the current debate surrounding personal disclosure and its relationship to intersubjective perspectives. Clinical vignettes help elaborate the issues, providing an integration of theory and practice, and one that is consistent with social work's attention to the environment. [ABSTRACT FROM AUTHOR]

Reparative therapy is a process through which reparative therapists believe they can and should make heterosexuals out of homosexuals. At the present time, most professional regulating bodies have banned the use of reparative therapy. In addition, reparative therapy is not supported by any reliable quantitative or qualitative studies. In spite of the lack of empirical substantiation, reparative therapists continue to practice, arguing that prior quantitative studies, as well as client self-determination, validate their methods. With a knowledge base originally rounded in psychoanalytic theory, current applications of reparative therapy cross not only scientific and psychological, but also social, political, and religious boundaries. The current trend promoting reparative therapy occurs through the conglomeration of the social, political, and religious dimensions of organizations that champion the cause of creating former homosexuals. Persons who identify as former homosexuals espouse the saving races of a mixture of reparative therapy with various forms of religious counseling, on occasion offered by faith-based providers. The purpose of this paper is shed new light on the process and theory behind reparative therapy. This paper will attempt to provide social work clinicians with the knowledge necessary to understand and formulate an informed opinion about the use of reparative therapy for homosexuality. [ABSTRACT FROM AUTHOR]

This paper presents an exploration of the concept of hope in clinical and developmental contexts. Traditionally, psychoanalytic theory has emphasized pathological aspects of development and, not surprisingly, the subject of hope has been neglected. Although the therapist's hope and how it impacts on the treatment is within the purview of the paper, the predominant focus is on the patient's hope and the dimension of mutuality in the treatment that fosters it. A case example is provided to illustrate the "unfreezing" (Winnicott, 1954) of unconscious hope in a phase of treatment I call the "phoenix juncture." Connections are drawn between the capacity for reflection and hope. The paper concludes with a discussion of a view of hope as problematic or regressive, along with a selective literature review. [ABSTRACT FROM AUTHOR]

The diversity of today's client population has required that psychotherapy training confront the importance of cultural competence in graduates. Approaches in this area of education create dynamic tensions between stressing therapist openness to diversity and therapist knowledge of clients' cultures. This paper proposes that this attitude-knowledge dilemma in psychotherapy education can be reconciled by helping trainees develop an empathic response capable of transcending cultural differences. Cross-cultural empathy helps provide the therapist with a coherent and familiar means of maintaining affective receptivity in the therapeutic encounter with clients while making use of a repository of information about clients' cultures. Such empathy can also be a base for building the skills needed to develop collaborative relationships with clients who are often disempowered and distrustful. The paper examines approaches and resources for training psychotherapists in cross-cultural empathy. [ABSTRACT FROM AUTHOR]

A focus on spirituality has become in vogue for the media as well as for professional conferences, journals, and schools of social work. Likewise, our clients are struggling with how to integrate religion and/or spirituality with their therapy. The premise of this paper is that we have a role in assisting our clients with this integration and to consider some of the current postmodern approaches. However, in attempting such an integration it is important to retain certain parameters and guidelines that have been helpful to our clinical work. This paper will examine how to make room for religion and spirituality in psychodynamic psychotherapy and the ways in which constructivism can be helpful in this process. The influences of psychodynamic theories and postmodernism shape the discussion in the following areas: definition of terms, self-awareness, deconstruction of clients' narrative, assessment of strengths and vulnerabilities, and reconstruction of a useful narrative. [ABSTRACT FROM AUTHOR]

At least as far back as Plato and Aristotle, psychology began as a stepchild of philosophy. The establishment by Wilhelm Wundt in 1879 of the first formal psychological laboratory focused on studying psychophysiological phenomena was psychology's declaration of independence as a discipline. By positioning itself as the application of natural-science-based, empirical methods involving quantitative, group-based approaches to psychological topics, the discipline consolidated its independence and its societal status and clout. This paper first summarizes these developments, to highlight the causes of psychology's historical resistance to qualitative case studies, and to qualitative research generally. I then briefly review three movements that have stimulated psychology to slowly but surely embrace qualitative case study research, with the addition of complementary, quantitative data: the rise of postmodern philosophy, the related 'cognitive revolution' in psychology, and the 'mixed methods' model of research in the social sciences that synergistically combines qualitative and quantitative methods. The result of this embrace, in the context of psychology's established science-oriented identity, has been for psychology to add quality-of-knowledge guidelines for elevating the yield of case study knowledge. This result is illustrated by three examples: Kazdin's (J Consult Clin Psychol 49:183-192, 1981) strategies for reducing threats to the validity of conclusions from case studies; Elliott, Fischer, and Rennie's (Br J Clin Psychol 38:215-229, 1999) development of methodological standards for both quantitative and qualitative research; and my own work in developing the Pragmatic Case Study (PCS), which particularly reflects three of the recent trends in psychology: pluralism, pragmatism, and the mixed methods approach. Comparisons between organized social work's and organized psychology's approach to psychotherapy training and research is noted, with the two fields starting off in opposite directions and recently coming together. [ABSTRACT FROM AUTHOR]

Bullying behavior and the impact of bullying behavior on children and adolescents has received considerable attention in empirical and clinical literature over the last two decades. Increasingly, empirical research is demonstrating that the psychological effects of being bullied persist into adulthood. There is less literature available that describes clinical processes with adults who were bullied as children. After reviewing the literature that discusses the long-term effects on adults of being victimized by bullies, and the literature that describes hegemonic views of masculinity, this paper gives a detailed clinical illustration in which the victimization of the client as a child becomes a core feature of the psychotherapy. Of importance, the client needed to reshape his view of masculinity as he worked through the trauma of having been bullied as a child. Recommendations for further work are given. [ABSTRACT FROM AUTHOR]

An indispensable goal of intensive psychotherapy is to modify areas of the superego which are unreasonably harsh and punitive--yet, surprisingly little is written on this topic. In this paper, after discussing various aspects of the superego, I recommend an active treatment technique which involves educating the patient, over time, about how pervasive and punitive is--for lack of a better word--the conscience--of his or her mind. During this process, one can expect a softening and lessening of the patient's punitive superego and an expansion of the patient's benign or benevolent superego, as the patient begins to identify with and introject more of the compassionate attitudes which have been imparted and experienced in the intimate relationship of psychotherapy. [ABSTRACT FROM AUTHOR]

Traditional technique guided the effective psychotherapist more toward restraint of self than active use of self. Contemporary trends in technique are moving more toward encouraging the therapist to be aware of and use his or her "real" self in the relationship with clients, in other words to loosen the rigors of anonymity and neutrality in service of genuine relating and its attendant growth-enhancing potential. The authors of this paper offer the argument that the application of what you know as a psychotherapist (that is the accumulation of knowledge and techniques from professional education and training) can only be helpful and effective if you are aware of how who you are as a person in the room with the client (that is the accumulation of your own personality traits, personal belief systems, and psychology in the relational matrix with the client) is influencing the therapy. Support for this argument from the clinical literature provides the theoretical bases for three processes outlined in the paper which will guide the effective psychotherapist in integrating the personal self with the professional and technical self: 1) inventory of self; 2) development of self-knowledge; and 3) acceptance of risks to self. [ABSTRACT FROM AUTHOR]

In this paper I will introduce the basic concepts of dance therapy and show how dance therapy could be viewed self psychologically. A clinical example will be presented, discussed and critiqued utilizing self psychological concepts. A brief discussion will follow that appraises the potential of blending self psychology and dance therapy together. This is a speculative paper but it may provide a basis to further develop self psychology within dance therapy. [ABSTRACT FROM AUTHOR]

HIV Illness is accompanied by a psychological course determined by the disease progression. The Life Course of HIV Illness has two phases which consist of eight basic Task-States and eight general themes which traverse these task-states. The paper focuses on a detailed description of phase one-Living with the Illness. The concepts are illustrated with case material. The overall goal of this paper is to introduce the broad notion of the Life Course of being in the HIV spectrum and its psychotherapeutic implications. [ABSTRACT FROM AUTHOR]

This paper will address the problems faced by the hearing impaired psychotherapist with a particular emphasis on the alliance in psychotherapy. The author will address the unique problems facing the hearing impaired therapist in clinical practice as well as the strategies which can be utilized to manage the treatment process. [ABSTRACT FROM AUTHOR]

A particular psychotherapeutic procedure described by the authors as ‘The Vitalizing and the Revitalizing Experience of Reliability,’ is used as an adjunct to enhance the effectiveness of the treatment. Characteristically, it is a nonmanipulative, nonseductive procedure used during particular stressful times with certain patients—adults as well as children—to facilitate a confirmation of the self as separate from others. It should also instill in the patient a feeling of increased safety and reliability as well as promoting basic trust in self and others with the ultimate goal of reintegration of a fragmented ego. Such an adjunct can take various forms. The one described here is a highly controversial one, physical touch. Two clinical examples are given which emphasize transferential and countertransferential considerations. The paper describes the delicate balance between discipline and flexibility required by the therapist. [ABSTRACT FROM AUTHOR]

The Bogolob paper on "Tape Recorders in Clinical Sessions" (this volume) contains valuable perspectives on the use of tape recording in psychotherapy, but it fails to adequately develop the concept of client reaction to taping when it classifies negative transference reactions as psychopathology. This paper offers a variation on Bogolob's themes by suggesting that object relations theory offers a more useful framework for interpretation of therapist and patient behaviors following introduction of tape recording in psychotherapy sessions. [ABSTRACT FROM AUTHOR]

This paper addresses the integration of developmental theory and family system theory. It is based on the assumption that the combination and integration of these two sets of theory gives the social work clinician the richest possible base for diagnostic assessment and intervention. Two points of intersection of these theories, birth and mate selection, are utilized to highlight the natural linkages between the theories and to demonstrate the combined power to more fully inform clinical practice. [ABSTRACT FROM AUTHOR]

The article discusses the author's response to the critics of his paper which focuses on psychodynamic therapy. According to the author, he was very pleased to have the opportunity to present his views on an important issue in social work which is the newer modalities. He was also glad to have experts critique his paper. The author agrees that his perspective is a psychoanalytic view of the human being. However, he indicates that he would not advocate for a long-term one-to-one treatment for everybody. He contends that the modal client in social work practice is a very troubled person.

Generally the literature of social work conveys a negative attitude toward the use of clinical social work with Chicanos. These attitudes result from assumptions that have not been empirically tested. Nevertheless these assumptions have been accepted as valid. This paper identifies and discusses these assumptions in the light of the nature of clinical social work and its objectives. The conclusion reached is that clinical social work is not alien to the needs of Chicanos and can be used successfully with them when the therapist has an understanding of the cultural system and can provide therapy within its framework. [ABSTRACT FROM AUTHOR]

Ten days after the Symbionese Liberation Army's ‘shoot out’ in Los Angeles in 1974, the Cedars-Sinai Medical Center, Department of Family Child Psychiatry, Thalians Community Mental Health Center, sent a crisis team of three psychotherapists to a school in the black community. The psycho- therapists used an art therapy approach with a third grade classroom of 21 black children. The team's procedure helped the children ventilate their reactions to a frightening event which occurred in their neighborhood. This paper describes the art therapy techniques which were utilized, the children's vivid pictorial and verbal expressions accompanied by the. psychological aspects of their responses. [ABSTRACT FROM AUTHOR]

The paper analyzes the therapeutic use of a soap opera discussion group with psychiatric in-patients. Through the use of media, patients are allowed to distance their concerns. The techniques are similar to play therapy with children or to projective testing. Individual themes and programs are discussed. The paper relates media to the collective unconscious and mythology. Although the research for this article was done with in-patients, the observations could be applied to other therapeutic groups. [ABSTRACT FROM AUTHOR]

The biological, psychological, and social developments that naturally occur as we age have repercussions in our work as therapists. Indeed, aging presents a developmental challenge to both clinicians and patients. Shifts in professional and personal identity as well as perception of practice are common for therapists. This is especially true for therapists who have experienced long careers over 30 or 40 years and have had the benefit of reflecting on these changes. We experience our therapeutic relationships in new and meaningful ways that create profound lessons about our patients and ourselves. Our focus in the paper is limited to older clinicians in the center of the advanced aging process, roughly 60-75 years of age, which includes those in transition from middle to older adulthood. [ABSTRACT FROM AUTHOR]

The ascendancy of the cyber world has led to increasing client demand for online counseling and a dramatic growth in cyber counseling, a trend that is expected to continue in the coming years. Recognizing the need for social workers who can competently utilize communication technology in their practice, we developed a 4-year pilot project as a practicum in which second year MSW students provided cyber and face-to-face counseling to undergraduate students who presented with a range of issues. The purpose of this paper is to report on an exploratory study which examined the perspectives of the student interns and the undergraduate student clients, in order to illuminate benefits and challenges that emerged. Twenty-four MSW student interns and 34 undergraduate student clients who utilized cyber counseling on at least one occasion participated in interviews that were transcribed and analyzed. Both the MSW interns and the undergraduate student clients reported that cyber counseling provided practical and relational value and that the written aspect was particularly beneficial in facilitating clients' disclosure of sensitive issues. Different perspectives about maintaining connection in the relationship emerged, suggesting challenges for social workers when learning to use cyber in counseling. [ABSTRACT FROM AUTHOR]

Clinical social work practice has been significantly impacted by the evolution of electronic communication through the development of cyber technology. The increased methods for electronic communication raise questions about the impact of electronic communication on patient confidentiality. This paper will review the way that clinical social work ethics have addressed the use of electronic communication with clients, insurers, or other professionals. The history of confidentiality is briefly reviewed. The Health Insurance Portability and Accountability Act will be discussed as a new context for confidentiality in clinical social work practice. [ABSTRACT FROM AUTHOR]

The increasing popularity of the Internet and social media has generated concerns and disputes about their effects on brain, behavior, and relationships. While many positive outcomes are associated with cybercommunication, some individuals experience negative consequences. This, in turn, has roused theoretical and clinical debates about the impact of technology on psychotherapy and the stances therapists should take in their own work with clients. Understanding the emerging digital culture, which includes how the Internet, social media, video games, reality, identity, relationships, and the self are experienced and managed, is thus important if clinicians are to carefully consider and understand the modern relevancy, patterns, and meanings of clients' communications with and about technology, as well as the possible use of social media as a therapeutic tool. This paper considers those questions by evaluating research on the effects of technology use and the implications of that research for psychotherapeutic practice and theory, with a particular emphasis on how psychoanalytic therapists have approached the topic. [ABSTRACT FROM AUTHOR]

This paper highlights forgiveness therapy, a therapeutic approach that has received limited attention in the social work literature. This study represents a beginning exploration of its cross-cultural application. Theoretical and empirical perspectives on forgiveness and forgiveness promoting psychotherapy are provided, and Enright's pioneering process model is delineated. A case study of the utilization of forgiveness therapy with an Israeli Bedouin-Arab woman who experienced a traumatic interpersonal injury within the polygamous family is presented. LaRoche and Maxie's guidelines for conducting cross-cultural psychotherapy are utilized to examine important dynamics that emerge in the case study. These authors' recommendations, which are consistent with a process-oriented conceptualization of culture, as well as intersectionality, appear potentially useful for informing the transcultural application of forgiveness therapy. Future research questions and directions related to the utilization of forgiveness promoting psychotherapy with diverse populations are considered. [ABSTRACT FROM AUTHOR]

This paper provides a consideration of a broadened scope of pathological narcissism, with particular attention towards the hidden and vulnerable aspects of this clinical phenomenon. The narcissism construct is briefly reviewed, along with contemporary issues in understanding the different presentations of narcissistic dysfunction. Selections from the theoretical literature are then explored in order to offer a nuanced conceptualization of the vulnerable side of pathological narcissism. Clinical implications of these perspectives are then discussed, along with clinical case material, to illustrate the presentation and treatment of narcissistic vulnerability. [ABSTRACT FROM AUTHOR]

In their efforts to learn the skills involved in the use of self, clinical social work supervisees are faced with the daunting task of integrating information coming not only from the patient but also from their own complex set of responses. The clinical supervisor serves a key role in guiding the trainee through this process. Grounded in contemporary psychodynamic theory, this paper discusses an approach to helping the supervisor model the use of self in the context of the supervisory relationship. A supervisory case example is used to illustrate. [ABSTRACT FROM AUTHOR]

With mounting evidence for its efficacy in the treatment of borderline personality disorder and related problems and increasing dissemination nationally and internationally, front line clinicians in practice settings are increasingly aware of dialectical behavior therapy (DBT). Indeed, it is likely that this treatment is reaching individuals who practice from a variety of theoretical frameworks, such as psychodynamic, humanistic, cognitive, or some combination thereof. Therefore, this paper considers the ways in which DBT is an integrative approach, as well as the issues that may arise in the integration of DBT with other theoretical frameworks or with practices spawned by these alternative frameworks. We recommend that therapists practicing DBT adhere to the behavioral and dialectical theoretical foundations of the approach, in order to provide therapy that is effective, coherent, and consistent. [ABSTRACT FROM AUTHOR]

The therapeutic dyad of clinician and client affiliated with rival groups in a violent conflict shares many features that complicate psychotherapy with persons of different ethnic, racial, and cultural groups, including lack of knowledge, negative stereotyping, differences in fundamental values and world views, and power differentials. Although a great deal has been written about these matters, very little has been written about the therapeutic dynamic where therapist and client are affiliated with different sides of a violent political conflict. Based on the sparse literature on the subject and on the clinical experiences of the author and her colleagues, this paper discusses three features that characterize this dynamic, which do not appear in the same way in therapy involving dyads of different races, ethnic groups, or cultures. These are the presence of the 'enemy' in the consulting room, the therapist's feelings of mistrust towards the client as a representative of the opposing group, and the client's feelings of guilt towards the therapist as a representative of the injured group. The impacts of each feature on the therapist, client, and the therapeutic encounter are explored and suggestions are made for dealing with them. The hope is that professionals' awareness of these issues will help improve the quality of psychotherapy with persons on the rival side of a violent political conflict. [ABSTRACT FROM AUTHOR]

Since the initial dialogues on the treatment relationship began, a hierarchical structure of our profession was set forth. This was largely created by Sigmund Freud, often considered the initiator of psychotherapy and psychoanalysis. Our profession was characterized by a neutral, distant practitioner who performed his work upon an unknowing patient. The reality of the multiple complexities of this relationship has become clearer over time. This paper seeks to examine the steps that have taken us from the initially distant and non-mutual psychotherapeutic relationship to the more egalitarian and co-created format that many clinicians are working in today. Love, in both its absence and presence, is examined as a central concept and tenet of psychotherapy. [ABSTRACT FROM AUTHOR]