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As a core component of multicultural orientation, cultural humility can be considered an important attitude for clinical supervisees to adopt and practically implement. How can cultural humility be most meaningfully incorporated in supervision? In what ways can supervisors stimulate the development of a culturally humble attitude in our supervisees? We consider those questions in this paper and present a model for addressing cultural humility in clinical supervision. The primary focus is given to two areas: (a) modeling and teaching of cultural humility through interpersonal interactions in supervision, and (b) teaching cultural humility through outside activities and experiences. Two case studies illustrating the model are presented, and a research agenda for work in this area is outlined. [ABSTRACT FROM AUTHOR]

Psychiatry and related mental health fields, in particular psychotherapy, have a long history of close ties with the humanities. That bond has weakened, however, over the last few decades as medicalized views of mental health and treatment have emerged. In this paper, we explore the potential of the reintroduction of the humanities, specifically novels and related literary genre, into the supervision of student clinicians working with clients who have psychosis. We believe that incorporation of novels and related literary genre into supervision can lead to unique and deepened understanding of the experience of psychosis, and can create an opportunity for a working therapeutic alliance. The potential mechanisms that create these unique opportunities to understand psychopathology are explored, and considerations for the implications for treatment, training, and future research are presented. [ABSTRACT FROM AUTHOR]

Early attachment relationships and their inherent emotional regulation formatively effect psychoneurobiologic development. Implicitly learned relational interactions begin within the context of such relationships, and as habitual responses to strong emotions, such as fear, ultimately define character. The psychotherapeutic attachment relationship can positively affect change in developmental processes compromised in earlier relationships, influencing character change. The early attachment relationship is evaluated for features that become relevant as the therapeutic attachment relationship and real relationship-the realistic and genuine elements of the therapeutic relationship, affect psychoneurobiologic change in the patient. This paper asserts that the real relationship deepens therapeutic attachment relationships, improves emotional regulation processes, and stimulates further development of processes such as mentalization. Current research studies are considered regarding areas of the brain potentially affected in psychotherapeutic processes. [ABSTRACT FROM AUTHOR]

Cognitive Behavior Therapy (CBT) is the evidence-based treatment of choice for Obsessive-Compulsive Disorder (OCD). The central technique of this approach is Exposure and Response Prevention (EX/RP). Examination of EX/RP treatment of OCD reveals severe shortcomings. The technique, while generally quite effective, cannot deal with patients who are unable to comply with EX/RP's difficult regime, resulting in a significant percentage of patients who refuse treatment and dropouts. Also, for optimal results, the therapist should be present while the patient carries out EX/RP therapy. This severely reduces the therapist's resources since leaving the clinic and being personally present during EX/RP in the patient's real life circumstances is not something therapists can do easily. These limitations acutely compromise the applicability of this technique to clinical practice. Research into Cognitive Therapy without EX/RP does not show superiority to EX/RP. In this paper, I illustrate a Strategic/Behavioral Treatment (SBT) for OCD that easily and elegantly overcomes the limitations of Cognitive Behavioral Therapy (CBT) treatment (thereby increasing its effectiveness), present three case studies, and offer suggestions for further research. [ABSTRACT FROM AUTHOR]

The psychiatric consultation has not been adequately exploited as a therapeutic device. Although, the original abstinent model for psychodynamic psychotherapy has become more flexible, passive listening with interventions to elicit diagnostic "data" remains the prevailing mode in psychiatric consultation. In this paper I develop the idea of the consultation as an active process (Viederman, M., 2002) that engages the patient emotionally for therapeutic effect. [ABSTRACT FROM AUTHOR]

Effective intercultural psychotherapy generally has been conceptualized in terms of a specific knowledge and skills base, combined with relevant attention to the practitioner's cultural attitudes and beliefs. Although such an approach continues to be the gold standard in the field, it has yet to be demonstrated that these components are either necessary or sufficient for effective treatment. This paper presents an approach to intercultural therapy based on Gadamer's philosophical hermeneutics. Humans are always in the process of making sense of the world around them, a process which is predicated on culturally given preunderstandings. Cultural difference means that the preunderstandings are rarely mutual, and therefore, communication and psychotherapy are often problematic. These preunderstandings often show up in the form of racial and ethnic prejudice and the therapist is rarely aware of this. Therapist preunderstanding influences all aspects of the psychotherapy process, such as treatment planning interventions chosen, and the therapeutic relationship. Recommendations are given for improving the intercultural therapy process, and draw strongly on the twin notions of the dialogical relationship and cultural imagination. [ABSTRACT FROM AUTHOR]

This paper makes a case for listening and its role in establishing and maintaining meaningful psychotherapeutic relationships. Further, it examines those factors that have contributed to the devaluation and current decline of listening in mental health care. These factors include the abuses of managed care, the marketing and misuse of psychotropic medications, the growth of brief, manualized, empirically supported treatments (ESTs), and the lack of appreciation for unconscious processes and countertransference in the appeal, development and delivery of these interventions. [ABSTRACT FROM AUTHOR]

The term "boundary violation" has become synonymous with unethical practice in psychotherapy, prompting a "black-or-white" view among clinicians and boards of review. But the current conceptual ambiguity about boundary interventions subjects clinicians to after-the-fact second-guessing that can be professionally ruinous at worst and may contribute to stultifying defensive therapeutic rigidity at best. It is crucial to demarcate the differences between boundary violations and boundary crossings (to be defined below) as clearly as possible, to describe the "gray areas" of each, and to recognize the heterogeneity of boundary violations and boundary crossings. These matters are of additional importance to those who teach, train, and supervise the next generation of clinicians. This paper will attempt to delineate a more clinically realistic and useful view of boundary crossings than has been proposed before, and illustrate the practical advantages of recognizing the spectrum of boundary interventions. [ABSTRACT FROM AUTHOR]