Search

Borderline personality disorder is a prevalent psychopathology; thus, most graduate students in psychology, residents in psychiatry, and early career clinicians will encounter patients with this disorder in the course of their training or initial professional practice. This paper provides clear and concise guidelines for conducting treatment geared toward the clinician's developmental level. It builds upon the knowledge and skills that are typically acquired during graduate education and training to provide an accessible framework for undertaking psychotherapy with patients who have borderline personality disorder. This paper draws upon common psychotherapeutic factors and existing evidence-based treatments for the disorder to identify principals and interventions that are likely to contribute to therapeutic action. It uses behavioral, cognitive, and psychodynamic interventions to address the patient's multidimensional psychopathology. This approach offers a coherent and integrated treatment framework for the beginning psychotherapy practitioner. [ABSTRACT FROM AUTHOR]

During the last several decades, brief psychotherapeutic approaches to mental health treatment have become increasingly prevalent. This paper describes brief psychotherapy and provides a brief review of the relevant empirical literature. Therapists who are unfamiliar with brief psychotherapy will find that this paper provides a concise introduction to the essential processes and outcomes of this therapeutic approach. [ABSTRACT FROM AUTHOR]

The paper describes the changes produced in the practice of dynamic psychotherapy when conducted within a circumscribed region. The authors discuss changes in anonymity, roles, and transference relationships for both therapist and patient. The paper demonstrates these effects on the therapist's professional training, his practice, and his family. [ABSTRACT FROM AUTHOR]

This paper provides a basic introduction to using method of levels (MOL) therapy with people experiencing psychosis. As MOL is a direct application of perceptual control theory (PCT), a brief overview of the three main theoretical principles of this theory--control, conflict, and reorganization will be outlined in relation to understanding psychosis. In particular, how these principles form the basis of problem conceptualisation and determine what an MOL therapist is required to do during therapy will be illustrated. A practical description of MOL will be given, using case examples and short excerpts of therapeutic interactions. Some direct contrasts will also be made with cognitive behaviour therapy for psychosis (CBTp) and psychodynamic approaches (PA) in order to help illustrate the theory and practice of MOL. [ABSTRACT FROM AUTHOR]

Parents facing a child's illness is difficult, nearly unbearable. In addition to the fear for their child's wellbeing, medical tests--even the entire health care system--seems to intrude upon family life, interrupting the family routine, disrupting the ability to live a normal life, and sometimes reintroducing thoughts of unprocessed traumas from the parents' pasts. This paper will explore how a therapist can expose how deep personal secrets-rejection, disgrace, disappointment--and subsequent feelings of guilt and shame arise during these crises, propose how to work with parents, and assist parents in processing these secrets [ABSTRACT FROM AUTHOR]

What do we know clinically and empirically about the education of psychotherapy supervisors? In this paper, I attempt to address that question by: (1) reviewing briefly current thinking about psychotherapy supervisor training; and (2) examining the available research where supervisor training and supervision have been studied. The importance of such matters as training format and methods, supervision topics for study, supervisor development, and supervisor competencies are considered, and some prototypical, competency-based supervisor training programs that hold educational promise are identified and described. Twenty supervisor training studies are critiqued, and their implications for practice and research are examined. Based on this review of training programs and research, the following conclusions are drawn: (1) the clinical validity of supervisor education appears to be strong, solid, and sound; (2) although research suggests that supervisor training can have value in stimulating the development of supervisor trainees and better preparing them for the supervisory role, any such base of empirical support or validity should be regarded as tentative at best; and (3) the most formidable challenge for psychotherapy supervisor education may well be correcting the imbalance that currently exists between clinical and empirical validity and "raising the bar" on the rigor, relevance, and replicability of future supervisor training research. [ABSTRACT FROM AUTHOR]

In this paper, the case is made that providing therapy to a client can be therapeutic for the therapist. Therapist change is not intentionally sought nor professionally delivered, but is from those client interactions experienced as healing. The possible mechanisms of change for the therapist include exposure of much about him- or herself, being "on the line" in therapy, and the therapeutic relationship as a collaborative, two-way system. In the collaborative system, much might affect a therapist, including how the client understands and reacts to the therapist's disposition, motivation, self-disclosure, and skill and what the client reveals about his or her life that may lead the therapist to a new sense of her or his own life. [ABSTRACT FROM AUTHOR]

Dealing with children who have disruptive behavior disorders can evoke feelings of frustration and anger in their therapists. D.W. Winnicott discussed the complexities in the treatment of enraging patients in his article "Hate in the Countertransference" (1949). In the following paper, I will depict the relationship between limit setting, projective identification dynamics, and enraging behavior in the treatment of a provocative latency-aged boy. I will argue that poor limit setting caused by powerful projective identification dynamics were central to the pathology of the boy and his family. These dynamics partially repeated in the boy's treatment--an outcome of which Winnicott had warned. The repetition contributed to the boy becoming physically out of control in my office and led to a disruption in his treatment. The establishment of solid limits by addressing projective identification forces was necessary for the improvement in the disruptive behavior of the child. [ABSTRACT FROM AUTHOR]

Experiential Psychotherapy originated in Gendlin's Philosopy of the Implicit. Some of its main concepts are bodily felt sense, fresh emergence of words from the felt sense, and carrying forward the implicit with small steps of change. Presented in this paper are many specific examples of what a therapist may say to the client to encourage the bodily felt sense. Dealing with three obstacles to forming a felt sense, intellectual speculation, drowning in emotions, and self-attacking are discussed. The philosophical concepts in the focusing-oriented school of therapy enable therapists to relate any psychological theory to the client's ongoing experience, allowing therapists from any theoretical orientation to practice in a focusing-oriented way. [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]

Therapists who are accustomed to operating in a world where gender roles are becoming increasingly androgynous may underestimate how foreign the experience of psychotherapy can be to "traditional" men. This paper describes the occurrence of transference and resistance encountered by female therapists when seeing male patients at a Veterans Administration (V.A.) Medical Center who identify with traditional American male gender roles. The discussion is informed by recent advances in the theory of male gender identity development and yields new insights into the typical defenses men may bring to the early phases of psychotherapy. Case examples from the authors' practices illustrate strategies for intervening with resistance and enhancing the therapeutic alliance. Common countertransference issues encountered by therapists working with "traditional" men are also discussed. [ABSTRACT FROM AUTHOR]

Forensic experts agree that the doctrine of informed consent now applies to psychotherapy. The optimum level of detail and content in this interaction remains nebulous. This study examines opinions and practices of therapists. The authors administered a survey regarding this subject to 231 psychotherapists. Six scales were constructed from this survey. High scores on these scales suggest more positive opinions regarding the application of the doctrine of informed consent to psychotherapy. Psychiatrists scored significantly lower on the Informed Consent (p=0. 005), Written Consent (p<0. 01), and Self-Disclosure (p=0.026) scales than other types of therapists (suggesting a more negative opinion of the application of this doctrine to psychotherapy). Interpersonal therapists scored significantly higher than psychodynamic psychotherapists on the Informed Consent (p=0. 003) and Patient (p=0. 003) scales. Psychodynamic psychotherapists scored significantly lower than therapists with different modalities on the Written Consent scale. This paper suggests that opinions and practices of informed consent for psychotherapy vary with the characteristics of the therapist. More research m this area could serve as a guide for therapists embarking on the process of informed consent or for professional organzations who wish to establish guidelines. [ABSTRACT FROM AUTHOR]

This paper investigates the psychological consequences of a social ethos that has emerged in the 1990s; the Bourgeois Bohemian (in short, Bobo) that claims that the bourgeois striving for financial success and status can be reconciled with the Bohemian striving for creative self-expression. An extended case history shows how a man in his thirties grappled with the inherent complexity and contradictions of the Bobo ethos. The question is raised how, as psychotherapists, we can deal with the individual patient's search for a good life amidst the growing pressure of the Bobo ethos, to get the best of all possible lives, the combination of authenticity and success. [ABSTRACT FROM AUTHOR]

Beginning psychotherapists often have mistaken assumptions about what it is that constitutes good psychotherapy and a good psychotherapist. These mistaken beliefs are counterproductive and may inhibit the development of appropriate psychotherapeutic skills as well as delay, or even prevent, the acquisition of an appropriate identity as a psychotherapist. This paper explores six common mistaken beliefs on the part of neophyte psychotherapists, providing a basis for exploration and discussion of key developmental issues in the genesis of a competent psychotherapist. [ABSTRACT FROM AUTHOR]

The hard-of-hearing psychotherapist is faced with special problems not laced by other therapists. This paper discusses these in a framework of reality, transference, and countertransference difficulties. Possible solutions are offered. The need of the therapist to work through his own feelings about his hearing deficit is discussed. [ABSTRACT FROM AUTHOR]