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Distress related to sexual orientation is a common focus in psychotherapy. In some instances the distress is external in nature as with persecution, and in others it is internal as with self-acceptance issues. Complicating matters, sexual orientation is a very complex topic producing a great deal of confusion for both clients and therapists. The current paper provides a four component model—sexual orientation dimensions, activation of these dimensions, the role of erotic fantasy, and social construction of sexual orientation—that in combination provide a comprehensive perspective. Activation of dimensions is a novel contribution not proposed in any other model. With improved understanding of sexual orientation issues, and utilization of this knowledge to guide interventions, psychotherapists can improve outcomes with their clients. Also described is how dimensions of sexual orientation relate to transgender. In addition to improving psychotherapy outcomes, the four-component model presented can help reduce discrimination and persecution, by demonstrating that the capacity for both homoerotic and heteroerotic behavior is universal. [ABSTRACT FROM AUTHOR]

When children are abused they utilize strategies already in place to cope with stress. These strategies develop during early life within the family and may be part of the unconscious framework formed within attachments and relationships. The case presented illustrates a teen-aged girl who was the victim of sexual abuse and experienced depression, PTSD and substance abuse. This paper describes the psychodynamic psychotherapy used to examine the patient's coping skills, which predated the abuse, and how these coping mechanisms were used to ameliorate her symptoms. [ABSTRACT FROM AUTHOR]

Deficits in metacognitive abilities, which enable persons to make sense of their own mental states and those of others, often are observed among persons with schizophrenia. To address these deficits we have sought to develop a metacognition-oriented form of psychotherapy that may foster self-reflectivity leading to the ability to think critically about delusional beliefs and to engage in and sustain healthy social exchanges. To illustrate Metacognition Oriented Therapy, we analyzed its application in an early psychotherapy session with a young woman who had disorganized schizophrenia. In this paper we specifically explore how the therapist followed a sequence of steps aimed at: 1) reconstructing episodes in life-narratives, 2) helping the patient name distressing emotions that appear in the narrative episode, 3) validating and normalizing the patient's experiences, 4) promoting awareness of emotional triggers and the links between affects and social behavior, and 5) validating emerging subjective experiences. We stress how these procedures helped the patient eventually become more able to start questioning her own delusional beliefs. The generalization of these procedures to the psychotherapy of schizophrenia is discussed. [ABSTRACT FROM AUTHOR]

The psychotherapy supervisor's development (i.e., the unfolding process of growth in being and becoming a supervisor) has long been considered a substantive issue in clinical supervision. Theory and clinical wisdom suggest that supervisors' level of development can have a significant and far-reaching impact on the supervision experience, potentially affecting supervisory alliance formation, in-session conceptualization and strategy utilization, and even the outcomes experienced by both supervises and patients. Consensus seems to be that there is a critical need for empirical study of psychotherapy supervisor development. But with a generation of theory and research on psychotherapy supervisor development behind us, what do we know (or not know); where does this area of inquiry stand today, and what do we need to know about supervisor development going forward? In this paper, I attempt to address those questions. I examine the last 30-year period (approximately) of supervisor development theory, measurement, and quantitative and qualitative study, provide a contemporary status report of sorts on this subject; and identify some important matters for research and practical consideration. Despite a generation of inquiry, the psychotherapy supervisor still remains the largely unknown party in the supervision experience. But that long-standing reality can be changed, some possibilities for doing so are presented, and the promise of supervisor development study is seen to be an ever-inviting hope that awaits realization. [ABSTRACT FROM AUTHOR]

While the constructs of the working alliance, parallel process, and counter-transference have long had transtheoretical appeal for many supervision practitioners, what empirical data-quantitative or qualitative-are there that support their use in psychotherapy supervision? In this paper, I attempt to address that question by: (1) identifying empirical, data-based efforts to research the supervisory working alliance (n=17), parallel process (n=7), and countertransference (n=1); (2) reviewing and determining for each study sample characteristics, measures used, procedure, analyses used, findings, and limitations; (3) identifying the primary conclusions that can be drawn from that review and analysis; and (4) considering the implications and directions for future supervision research and practice. While the data appear strongest for the supervisory working alliance and tentatively support its place in psychotherapy supervision, research on alliance, parallel process, and countertransference is still very much in its infancy and sorely limited empirically. Some avenues for remedying previous study deficiencies are presented, and the hope and caution of future research on these constructs are considered. [ABSTRACT FROM AUTHOR]

In this paper, an experiential process-directive approach is presented in which the therapist is guided by the Rogerian core attitudes for offering a therapeutic relationship and for intervening in a process-enhancing way. I elaborate on how interventions that originate in the therapist's empathic-resonance process influence the client's experiencing in a process-enhancing way. A process-diagnostic model, based on distinctions among different aspects of the experiential exploration process, forms the framework in which the various interventions are classified according to dominant process intention. Three major process intentions are distinguished: becoming aware of experiencing, regulating (increasing or decreasing) the intensity of experiencing so that it becomes possible to hold the experience in attention, and exploring that leads to further unfolding and change. Therapy excerpts illustrate this approach. [ABSTRACT FROM AUTHOR]

This paper examines the ramifications of a psychotherapist's self-disclosure stimulated by the film Gloomy Sunday (Barkow, N., 1988, Universal Pictures, 1999). It describes the five-year psychoanalysis of a depressed surgeon who made serious medical errors while treating family members. Analysis provided considerable symptom relief, but decades later the patient again became depressed. His depression was precipitated by his having made a major medical error while treating a family member, his daughter, which had an almost fatal result. The surgeon then resumed psychotherapy two times a week for three years. Cultural and professional similarities between psychiatrist and patient cemented the therapeutic alliance, but the patient's medical errors when treating his family members persisted. The psychotherapist's self-disclosure stimulated by the viewing of the film became a fulcrum for renewed investigation of the patient's childhood unconscious contributions to his psychopathology. It also stimulated self-analysis regarding counter-transference issues in the therapist which was related to his own perceptions of Nazis. The resumed treatment ameliorated the patient's tendency to make medical errors. The description of both treatments is intended to deepen the understanding of a "boundary crossing" intervention that assisted psychotherapeutic progress, and to contribute to further consideration of its benefits and risks. [ABSTRACT FROM AUTHOR]

In this paper, three major tasks are undertaken: 1. showing that our traditional understanding of the nature of emotions, which equates them with certain sorts of inherently private affective experiences that are brought about by various causal factors (esp., exciting events, cognitive interpretations, and biological states of affairs), does justice neither to the conceptual nor to the empirical facts; 2. presenting an alternative conception of emotions as a specific class of perceived relationships between oneself and some person, object, event, or state of affairs; 3. demonstrating how this relational conception of emotions heuristically suggests a far greater range of therapeutic options than does the traditional view. [ABSTRACT FROM AUTHOR]