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The objective of this article is to review how primary care providers – paediatricians, family practitioners, nurse practitioners - could address the use of substances by adolescents and respond to problematic behaviours and situations. Given the highly addictive properties of nicotine, adolescents should be supported in avoiding any consumption of tobacco or quitting if they already do so. Screening and investigation of substance use is usually not difficult, provided that it is processed in a neutral and empathetic atmosphere and securing confidentiality if the adolescent asks for it. Any type of substance use is potentially linked with adverse events such as injuries, violence, unplanned and unsafe sexual experience, alcoholic coma, 'bad trips' or unpleasant psychological experiences. As such, substance use should be identified and openly discussed with the adolescent. Moderate intermittent recreational use of legal and illegal substances (mainly alcohol and cannabis) should be carefully monitored over time, as it can lead to problematic use. Problematic use and substance use disorder require various interventions, including motivational interviewing, family counselling and psychotherapy, especially when substance use is linked with mental health disorders. Despite the importance of confidential care, parents or caregivers should be involved in problematic situations as much as possible. What is known: • While problematic use of substances is transient amongst many adolescents, it may be a threat to health and school/professional functioning • Primary care providers (PCPs) can address queries or offer preventive interventions to adolescents who use substances What is new: • Some interview tools can assist PCPs efficiently to identify problematic users of substances • There are effective approaches that PCPs can use to address problematic use by adolescent patients [ABSTRACT FROM AUTHOR]

Psychotherapists from all fields perform difficult and challenging work, trying to help their clients gain insight into their problems and make lasting changes in their thoughts and behaviors. Unfortunately, too often the work of a psychotherapist is minimized, neglected, or disregarded. Where departmental or conference awards may be presented regularly, public recognition for evidence-based and clinically-relevant published work is lacking. The present paper aims to acknowledge the most valuable recent accomplishments in the field of mental health assessment and treatment. Nominations were accepted for works published during 2017, papers of enduring value, and most valuable psychologist, and votes were cast by a panel of judges. These valuable contributions are recommended for all psychotherapists who hope to improve their work with clients. [ABSTRACT FROM AUTHOR]

This document introduces a special issue on technological applications in mental health and mental health services research. The advancements in computer technology have allowed for innovative applications in collecting and analyzing data related to mental health. The use of personal electronic devices and the internet provides a rich stream of data that can offer insights into individuals' mental health. The special issue includes papers on topics such as video therapy, measurements in daily life, and automated coding of psychotherapy sessions. These papers highlight the potential of technology in improving mental health outcomes and expanding the accessibility of mental health services. [Extracted from the article]

The principles of CBT emphasize the interactions among cognition, emotion, and behavior. CBT's origins lie in Stoicism philosophy and share similarities with the ideas of Confucianism, Taoism, and Traditional Chinese Medicine (TCM) in China. The idea of mind–body regulation in traditional Chinese culture has laid a cultural foundation for the promotion of CBT in China. This paper analyzes the applicability and challenges of CBT in China based on the current development of CBT in mainland China and the learning and practice of CBT therapists. It also explores the potential further development of CBT in China and the integration of CBT with the Chinese culture. [ABSTRACT FROM AUTHOR]

Terminating a therapeutic relationship can be a challenging phase with patients suffering from borderline personality disorder. Despite the critical importance of the termination phase, the proportion of psychotherapy literature devoted to the demands and challenges of this phase is small. This paper describes a mentalization-based approach to detect and intervene against such challenges. It is proposed that termination challenges, while operating through overlapping and interactive mechanisms, can be attributed to (1) patient factors, (2) therapist factors, and (3) therapeutic relationship factors. The paper has clinical implications and suggests that the aim of enhancing mentalizing capacities should include mentalizing the often complicated and mixed feelings associated with separation and loss of the therapeutic relationship. To facilitate this process, we propose the use of a "termination formulation", in which patients' outcomes and future goals are recapitulated in the termination phase of mentalization-based therapy. [ABSTRACT FROM AUTHOR]

Couple, marriage, and family therapists (CMFTs) are becoming more aware of clients' diversity. Model-specific research highlights the need for more culturally competent models and techniques. Some researchers argue that less emphasis needs to focus on developing culturally competent models and more attention placed on developing culturally sensitive therapists. Basing the principles of our paper on Fife et al. (J Marital Fam Ther 40(1): 20–33, 2014) meta-model, which places a therapist's way-of-being as the foundation of effective therapy, our paper aims to present a case for a therapist's way-of-being as the heart of effectively working with minority populations and culturally diverse clients. Common factors and cultural humility research speak to the importance of therapist factors in effective therapy outcomes. We will illustrate our points by presenting several case examples which highlight the impact a therapist's way-of-being has on work with minority populations. We will also outline clinical and training implications as we add to the therapist factors discussion regarding working with minority populations. [ABSTRACT FROM AUTHOR]

The new psychotherapists' law in Germany requires that future studies in psychotherapy enable students to evaluate the evidence base of psychotherapeutic methods based on established criteria. This article summarizes and applies the most important national and international criteria for evaluating the evidence base of psychodynamic psychotherapy including the criteria detailed in the Methods Paper of the Scientific Advisory Board Psychotherapy in Germany, the internationally influential criteria by Chambless et al. (1998) as well as the most recent criteria by Tolin et al. (2015). Criticism of the criteria for evidence assessment (e.g., the disorder-specific approach), current controversies (e.g., concerning the evidence base of long-term psychodynamic therapy and analytic psychotherapy, integrative psychotherapy frameworks versus specific treatment approaches), and the relevance of the participation of practicing psychodynamic psychotherapists in research projects are addressed. For the adequate assessment of the efficacy/effectiveness of psychodynamic psychotherapy, especially long-term psychodynamic therapy and analytic psychotherapy, it is necessary to include longer follow-up periods and also to assess changes in accordance with psychodynamic assumptions about therapeutic change processes. [ABSTRACT FROM AUTHOR]

This article investigates distances between therapists and their clients in their experience of the therapeutic alliance across the duration of the psychotherapeutic treatments in a naturalistic study. We looked at the working alliances from different vantage points—rupture, repair of ruptures, distances in the alliance impressions of both clients and therapists—and their correlation with treatment outcome. The only predictive variable of alliance ruptures was the inability of therapists to bond sufficiently with their clients regarding a sustainable working atmosphere, which could be identified through a continuous distant alliance rating by the therapists. Alliance ruptures in turn significantly predicted premature termination of treatments, whereas alliance ruptures per se did not necessarily predict treatment outcome. The paper discusses the possible role of the quality of therapists' attachment styles as a potentially crucial variable in an effective working alliance in psychotherapy. [ABSTRACT FROM AUTHOR]

Family therapists are increasingly called upon to work with individuals and families with medical issues, but often do not have sufficient background on the issue to be most helpful. The purpose of this paper is to help family therapists understand Parkinson’s Disease (PD) and its impact on the individual and his or her family. PD is the second most prevalent neurodegenerative disorder in the United States, following Alzheimer’s disease (Hirtz et al., Neurology 68:326-337, 2007). According to the Parkinson’s Disease Foundation, approximately 60,000 individuals are diagnosed with PD every year, and approximately one million Americans are currently living with PD. In this paper, we provide an overview of PD based on research and the second author’s many years of providing services for individuals with PD, as well as offer specific recommendations for providing family therapy using narrative, solution-focused and emotionally focused therapy based on the first author’s work as a family therapist with individuals, groups, and couples dealing with PD. [ABSTRACT FROM AUTHOR]

Historically, model integration was reserved for experienced therapists (Lebow, J Marital Fam Ther 13:1-14, . doi:). Currently, many marriage and family therapy (MFT) training programs encourage trainees to develop an integrative therapy approach. This relatively new phenomenon of encouraging integration during training is not often discussed. One challenge of developing an integrative approach to therapy practice is that trainees may not receive formal training in how to thoughtfully integrate models (Lebow, J Marital Fam Ther 13:1-14, . doi:). Training therapists would benefit from an explicit road map to integration, the common factors approach is one such roadmap. The common factors approach may be a useful integrational construct (Weeks and Chad, Guid Couns 19:57-64, . doi:) for guiding trainees in their initial understanding of model integration. The present conceptual paper presents a rationale for the usefulness of common factors in informing integration and supports a more prominent role of common factors in MFT training. [ABSTRACT FROM AUTHOR]

Children with Down syndrome (DS) have deficits in eye-hand coordination skills. Deficits in eye-hand coordination could negatively impact the acquisition of literacy skills. This paper presents the evaluation of BeeSmart, a gesture-based videogame for supporting eye-hand coordination and pre-literacy skills. The aim of this work is to investigate whether BeeSmart has the potential to support eye-hand coordination and pre-literacy skills of children with DS. A 10-week study with seven children with DS and two psychotherapists is presented. The results indicate that BeeSmart was perceived as a potential tool to support eye-hand coordination and pre-literacy skills. Three out of seven participants improved their eye-hand coordination and pre-literacy skills to some degree. The evaluation study also revealed some improvements that should be made to BeeSmart, such as a reward counter for children with DS with a higher cognitive level. More game sessions with BeeSmart is required to investigate at what degree of BeeSmart improves eye-hand coordination and pre-literacy skills of children with DS. [ABSTRACT FROM AUTHOR]

The paper aims at presenting the state of the art regarding systemic/family therapy in Greece, in relation to practice, professional and accreditation issues and training. It is argued that systemic/family therapy in Greece constitutes a lively and diverse terrain with roots in the 1960s and a rapid dissemination of the approach following the mid 1980s. The field's development in Greece is out-sketched by means of 'data' collected from a variety of sources, like web sites of associations and training centers, published articles and informal and semi-structured interviews conducted with seminal figures. First, a concise historical overview of the birth of systemic/family therapy is presented in relation to the wider socio-political context and the attempt for the reform of the psychiatric system in Greece during the 1980s. Second, a brief sketch of the existing associations as well as of the contexts where systemic/family therapy is practiced is outlined in relation to issues regarding accreditation and statutory regulations. Third, a non-exhaustive list of currently existing training programs is reviewed in respect of axis, like their content and structure, accreditation issues, entry requirements, etc. The paper concludes with inferences regarding the existing state of the art including future potential directions, whilst hinting to research ventures, which could enrich our understanding of both the history and the potential of the field in the Greek context. [ABSTRACT FROM AUTHOR]

Psychotherapy supervision has now celebrated its first centennial, is poised to move boldly forward into its second century of contribution to psychotherapy education, and seems perfectly positioned to further advance our knowledge about and practice of how to effectively facilitate, influence, and mentor our supervisees. Professional interest in and recognition of psychotherapy supervision appears to be at an all time high, and its value as a potentially alchemical educational event seems increasingly incontrovertible. But if supervision is to maintain and even enhance its substance and significance in 21st century psychotherapy education, what are the matters to which we as supervision practitioners, researchers, and theorists must vigilantly attend and vigorously address? In this special supervision issue of the Journal of Contemporary Psychotherapy, we would like to examine some of those matters. The topics that are addressed include: competencies, evidence-based practice, and supervising psychoanalytic/psychodynamic, cognitive/behavioral, humanistic/existential, and integrative/eclectic psychotherapies. The binding theme of 'pressing needs and impressing possibilities' will be evident throughout this journal issue. In this introductory paper, I briefly define psychotherapy supervision, consider its beginnings, provide a rationale for this special issue, and identify the specific questions that give focus and frame to each of the succeeding contributions. [ABSTRACT FROM AUTHOR]

This paper falls under the rubric of the sociology of knowledge, which bridges the gap between phenomenological philosophy and the human sciences (Berger et al., 1969). It presents an empirical investigation of the communicative construction of psychotherapeutic reality. I examine therapeutic talk and psychotherapists' reconstructions of the transition from state socialism in Germany in 1989. In both instances I show how psychotherapists' commonly shared interpretative conventions and rules of reasoning produce typical accounts. The first part of the paper shows how certain interpretative conventions and rules of reasoning organize therapeutic talk and interaction in general. The second part focuses on how the interpretative conventions typical of therapy also inform psychotherapists' interpretations of the transition from state socialism. [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]

Competent psychotherapists are necessarily skilled users of conversation. They must use conversation to carry out the interpersonal activities which comprise the essence of psychotherapy. This paper explores the relationship between conversational and therapeutic processes, examining transcripts of psychotherapy sessions taken from a variety of sources. Psychotherapy alternates between exchanges in which therapists elicit narrative statements by clients of their situation or problem and intervention exchanges in which therapists attempt to induce client statements reflecting insight. The paper focuses on preliminaries to therapeutic interventions which serve as transitions between these two types of exchanges, linking forthcoming interventions to the contexts which inspired them. One phenomenon examined is the use of topic maintenance and topic shift in conjunctive and disjunctive techniques for embedding interventions in the ongoing flow of interaction. Another activity is the structuring of confrontive and nonconfrontive intervention contexts. Confrontive interventions often involve disagreement and therapists may maneuver the interaction to be able to deliver these interventions in disagreement contexts. This paper demonstrates that for psychotherapists, conversational organization represents both their major technical constraint and their primary instrumental resource. Therapists use conversational organization to influence client participation, while at the same time resisting attempts by clients to influence their participation. [ABSTRACT FROM AUTHOR]

Psychotherapists often encounter generational differences between themselves and their adolescent clients. Understanding these differences can enhance the communication, interventions, and trust between the therapist and adolescent client. The use of text messages in the lives of adolescents has increased. While there is emerging literature on the significance of texting for an adolescent's feelings of connection with his/her peers, much less is known about the addition of this form of communication within counseling sessions. This paper uses one case of conjoint therapy with a father and daughter to explore these issues. The role of texting for the adolescent is explored, the role the texting inhabited in the sessions is discussed, and clinical significance of social media on psychotherapy are explored. [ABSTRACT FROM AUTHOR]

This paper seeks to expand on the supervision literature by exploring the experiences of five supervisors in training (SIT) as they navigate the transition from therapist to supervisor. Five key elements of the process of becoming a supervisor are highlighted; contracting, ethics, diversity, modalities, and troubleshooting. Each element is described in two parts: (1) information provided by current supervision literature and (2) by personal journal entries of SITs in an approved supervision course during their doctoral studies. The journal entries of the SITs describe the journey in forming their own supervision identity which included understanding how to include the five key elements in their own supervision with their supervisees. A postmodern approach was utilized to understand this process as well as shape the paper. The goal of this paper is to understand the experiences of supervisors who will shape the development of future therapists. [ABSTRACT FROM AUTHOR]

This paper outlines the development of pan European systemic thinking and practice. This development has been enabled and supported with the establishment of the European Family Therapy Association (EFTA). EFTA has evolved over the last decade from an organisation of individual members to an organisation of organisations-representing also national associations of family therapy and family therapy training institutes across 28 European countries. There are three sections to this paper: (1) a brief summary of the development of family therapy practice in Europe; (2) a brief summary of the work of the national associations of family therapy in EFTA; and (3) a brief summary of current concerns of some senior family therapists and family therapy trainers within the EFTA organisation. [ABSTRACT FROM AUTHOR]

Psychotherapy supervision has increasingly become or is on the fast track to becoming competency-based, evidence-based, particularized, and accountable. In this paper, I explore how that appears to be so by: (1) briefly considering the concepts of 'competencies' and 'evidence-based practice' as preeminent guides for psychotherapy supervision practice and training; and (2) briefly reviewing the current status, pressing needs, and future possibilities of psychoanalytic, cognitive-behavioral, humanistic-existential, and integrative psychotherapy supervision. Based on my examination, the following conclusions are proposed: (1) the supervision relationship, individualization, developmental differentiation, and self- reflection (for supervisee and supervisor) appear to be crucial cornerstones for the conceptualization and actuation of supervision process and practice across psychotherapy-based supervision approaches; (2) all indications suggest that three emphases- competency- based supervision, evidence- based practice, and accountability-will continue to substantially influence, affect, and inform psychotherapy supervision practice for its near and distant future; (3) psychotherapy-based supervision approaches will need to be and indeed appear to now be in the process of becoming increasingly particularized in how each of their respective approach-specific competencies are defined and explicated; and (4) psychotherapy supervision has come to be increasingly viewed as an educational process and practice that is best facilitated by: (a) a rich and enriching supervision training environment that vigorously addresses and attempts to meaningfully integrate declarative, procedural, and reflective knowledge bases throughout the supervisory endeavor; and (b) the considered and deliberate utilization of facilitative technology that has the potential to substantially enhance and expand the value of the supervisee's training/supervision experiences. Some discussion is provided about those four conclusions, and a retrofitted psychotherapy supervision for the new millennium is considered. [ABSTRACT FROM AUTHOR]

The article comments on efforts to correct therapists for their use of "myth" in family therapy practice. The myth concept should be understood, defined and applied according to perspectives drawn from the folklore field. Psychotherapy is a practice that most often takes place outside academia. When applied in therapies, the myth concept may need to be expanded, deepened and be adhered to a real life phenomenon. Ideation exists in dialectic relations between dominant expressions. Myth is a global concept, found in cultures and used in multitude of ways and contexts.

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]

This paper argues that one receives the calling to become a therapist to experience feeling real. Stated differently, therapists become therapists to heal themselves. Drawing on object relations theory, the author identifies five “wounds” therapists may consciously and unconsciously address by entering a therapeutic profession. The wounds are located in the capacity to believe, the capacity to imagine, the capacity for concern, the capacity to be alone, and the capacity of object usage. Achieving these capacities provides the therapist with a sense of wholeness, health, and holiness. [ABSTRACT FROM AUTHOR]

A total of 1196 persons conducting psychotherapy in Poland fully completed a nationwide online survey (or, alternatively, a paper and pencil enquiry) concerning their education, training, experience, and clinical work (professional environment, patients treated). The results are described in detail and compared with findings of similar studies from other countries. Among the primary findings were: (1) psychotherapy in Poland is conducted mostly by women (80 %); (2) almost all participants have an MA degree (91 %), including 75.2 % having graduated in psychology; (3) the therapists are well trained (mean number of training hours is above 942) and established (average experience is about 9.8 years), however, more than half of the therapists have no type of certificate; (4) 54 % of respondents identify with the integrative or eclectic orientation and, simultaneously, for 48.6 % of the therapists the most important approach is either psychodynamic or psychoanalytic; (5) the most common form of therapy is individual psychotherapy in private practice; (6) the majority of the therapists treat adult patients with anxiety or personality disorders. In sum, the results show that psychotherapeutic practice is well established in Poland and many indices are similar to those found in Western countries. [ABSTRACT FROM AUTHOR]

In this paper, we propose that therapist anxiety in the therapy room, especially anxiety stirred up by difficult or triggering clients, represents a challenge to effective therapy, and that effective management of this anxiety be considered as a necessary therapist skill for conducting quality couple and family therapy (CFT). We propose that effective therapists need to be able to manage their emotions, especially their anxiety, in order to truly help their clients. The failure to do this can lead to break downs in the alliance and the flow of therapy, and these deleterious effects can be prevented when therapists actively navigate their internal states through self-awareness and ongoing introspection. Bridging psychotherapy literature, we discuss specific strategies to this end, and make clinical recommendations for CFTs and CFT training programs. [ABSTRACT FROM AUTHOR]

A clinician's sense of hope is not easily maintained in the their-apeutic situation. Exploring the psychodynamics of hope in two interviews-One focusing on a community mental health psychotherapist and the other on a school social worker-this paper proposes that maintaining hope requires an intense affect state, an active blend of emotional and intellectual reflections in the mind of the clinician. Ongoing hope is the product of a delicate balance between a clinician's tolerance for the tragic in life and the expectations of positive treatment outcome. These reflections occur in an intrapsychic space, a point of juncture between the clinician's primary process longings/fears and secondary process thoughts. Hope is constructed in this space. It gains its language, form, and substance from the integration of personal experience, client observation and clinical theory. Reflective activity helps a clinician avoid disabling transference to a client and promotes identifications that lead to realistic treatment goals. [ABSTRACT FROM AUTHOR]

Conflict is not an aberration but rather part of the structure of human relationships. It is defined in this paper as consisting of four stages. Once the first stage (the dispute) is triggered, there is a high likelihood that the second (blaming) will occur, and the third (shame, guilt, or denial), and then the fourth (reparation, reconciliation, or retaliation). Three case presentations illustrate the conflict cycle in various clinical and nonclinical situations. The family therapist should be readily able to identify the cycle in clinical situations, and knowledge of it should prove fruitful in identifying pathogenic relating and in planning interventions and their timing. [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]

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]

This paper provides an intersubjective viewpoint on the challenging and disturbing clinical phenomenon of hopelessness, and suggests that therapists' careful balancing of accurate empathy for patients' profound despair with a belief in their ability to overcome it can help such patients develop and maintain a more hopeful state of mind. Clinical literature on hope and hopelessness is reviewed, as are pertinent countertransference issues related to working with this population so often erroneously viewed as ‘treatment resistant.’ The author presents two case examples to highlight her ideas. [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]

This paper will explore the concept that some creativity may be an effort to develop a container for an aspect of the self when the environment or, in early childhood, the mother is unable to provide containment for a part of the self experience. [ABSTRACT FROM AUTHOR]

Objectives: Buddhist non-attachment has been shown to be effective for improving mental health and wellbeing. Non-attachment refers to the ability to engage with phenomena without psychologically clinging to experiences or rejecting them. The present qualitative investigation sought to compare secular and Buddhist-informed counselors' and psychotherapists' perceptions of the non-attachment construct, including their views on its relevance for client-therapist practice. Method: Two data sets were collected. In Sample 1, semi-structured interviews were administered to nine qualified counselors and psychotherapists with limited prior knowledge of non-attachment or related Buddhist principles. In Sample 2, five Buddhist-informed counselors and psychotherapists completed an open questionnaire. Both data sets were analysed using Reflexive Thematic Analysis. Results: Analysis of the first sample generated four themes concerning participants' understanding of non-attachment: (1) misunderstanding non-attachment, (2) who non-attachment might be useful for, (3) potential impact on the therapeutic relationship and (4) the importance of experiential understanding on the part of the therapist. The analysis of Sample 2 generated two themes: (1) considerations for assimilating non-attachment, and (2) positive experiences of applying the construct in client-therapist contexts. Conclusions: The secular mental health practitioners in Sample 1 recognised the potential utility of non-attachment but harboured some misunderstandings as to its meaning as well as reservations regarding its suitability for all client groups. This was in contrast to Sample 2 participants, who felt that with appropriate therapeutic skill and discernment, non-attachment can be beneficial for a broad range of mental health conditions. Raising awareness of non-attachment amongst secular mental health practitioners is crucial to improving comprehension of the concept and its integration into client-therapist settings. Preregistration: This study was not preregistered. [ABSTRACT FROM AUTHOR]

Evidence-based and person-centred care requires the measurement of treatment outcomes that matter to youth and mental health practitioners. Priorities, however, may vary not just between but also within stakeholder groups. This study used Q-methodology to explore differences in outcome priorities among mental health practitioners from two countries in relation to youth depression. Practitioners from the United Kingdom (UK) (n = 27) and Chile (n = 15) sorted 35 outcome descriptions by importance and completed brief semi-structured interviews about their sorting rationale. By-person principal component analysis (PCA) served to identify distinct priority profiles within each country sample; second-order PCA examined whether these profiles could be further reduced into cross-cultural "super profiles". We identified three UK outcome priority profiles (Reduced symptoms and enhanced well-being; improved individual coping and self-management; improved family coping and support), and two Chilean profiles (Strengthened identity and enhanced insight; symptom reduction and self-management). These could be further reduced into two cross-cultural super profiles: one prioritized outcomes related to reduced depressive symptoms and enhanced well-being; the other prioritized outcomes related to improved resilience resources within youth and families. A practitioner focus on symptom reduction aligns with a long-standing focus on symptomatic change in youth depression treatment studies, and with recent measurement recommendations. Less data and guidance are available to those practitioners who prioritize resilience outcomes. To raise the chances that such practitioners will engage in evidence-based practice and measurement-based care, measurement guidance for a broader set of outcomes may be needed. [ABSTRACT FROM AUTHOR]

The present paper describes the development and evaluation of a standardized multi-component therapist training program in guided respiration mindfulness therapy (GRMT). GMRT is a manual-based, experimental clinical intervention involving concentrated focus on sustained self-regulation of breathing, application of mindfulness to emergent somatic experience and relaxation. Therapists ( n = 61) new to the approach attended a 2-day experiential workshop and were evaluated pre-post workshop for change in intervention knowledge, as well as change in mindfulness. These trainees also participated in post-workshop focus group sessions to explore perception of the intervention. A subset of 40 therapists participated in a second training component, and 14 of these were rated for competent delivery of the intervention during participation in a clinical trial. During training, therapists personally received the treatment giving the opportunity to assess treatment session ( n = 283) impact on sense of wellbeing. Results indicated a brief focused training program can equip therapists with basic knowledge and skills required to deliver the standardized manual-based treatment. Qualitative analysis of focus group sessions showed that therapists endorsed the intervention for clinical use and found it personally beneficial. This research provides a foundation for further evaluation of clinical effectiveness of the intervention. [ABSTRACT FROM AUTHOR]

It is widely accepted that those who provide psychotherapy for others benefit from experience in the client role; most clinicians do, in fact, seek their own therapy, as a sizable body of research indicates. Yet these studies address only one side of the phenomenon: the impact of personal therapy, usually early in their careers, on clinicians' subsequent practice. Little is known about what happens when seasoned clinicians move in the other direction--from the 'therapist chair' into, or back into, the 'client chair.' These are a special group of clients, reacting to therapy in ways that other groups do not. As this qualitative study of 30 clinical social workers who have returned to the 'patient chair' indicates, there is a unique struggle for identity and control. The paper explores the impact of that struggle on the therapeutic dyad and therapeutic frame, and concludes with implications and suggestions for further research. [ABSTRACT FROM AUTHOR]

Post-modernist family therapy allows for pragmatism, which is embedded within a linguistic system. This linguistic system is socially constructed in conversation, generates multiple meanings, and realities in the therapeutic process. Thus the role of post-modernistic therapists is to accept meanings and realities as constructed in context of therapist-client collaboration through conversations, making it possible for therapists to privilege clients' uniqueness, language, creativity, and resources in therapy. In privileging clients' uniqueness, language, creativity, and resources, family therapists utilize whatever works in creating efficacy in doing therapy. As a result, doing family therapy such as solution-focused brief therapy (SFBT) exemplifies therapists' utilization of clients' language to enhance therapeutic interventions. Family therapists using SFBT in working with clients utilize the interactional patterns that connect family dynamics: family interactional patterns involve language, which entail clients' metaphors. Metaphors emerge in everyday conversations and may support clients in developing solutions to problems. Metaphors have been shown to be effective in therapy, yet there is a gap in current literature discussing the utilization of clients' metaphors in SFBT interventions. This paper illustrates utilization of clients' metaphors and how they punctuate SFBT interventions in solution-focused building. Transcript excerpts from therapy sessions with a daughter and mother show their metaphors leading to solutions, metaphors as joining, and metaphors of power punctuating SFBT interventions and connecting patterns in solution-focused building. The utilization of clients' metaphors to punctuate SFBT interventions offers suggestions in expanding the practices of family therapy within a systemic context. [ABSTRACT FROM AUTHOR]

It is helpful for professional organizations, policy makers and regulators, third-party payers, and clients to have access to empirical data about family therapists and the practice of family therapy. Nevertheless, there is no such data available in China. This study attempts to fill this gap by profiling Chinese family therapists. A questionnaire was designed and delivered to family therapists and trainees. A total of 117 questionnaires were collected and analyzed. The findings show that the majority of Chinese family therapists are female, in the age range of 31-40 years, hold master's degrees, and attend continuous training programs that last 20-40 days over 2-3 years and short-term workshops for family therapy training. They are mainly motivated by the need for personal growth in their career choice. Most of them work in the institutional setting. They have worked in the counseling field for 6.6 years on average, and they have practiced family therapy for an average of 3.4 years. They perform counseling for 9.2 h per week, and 4 h involve working with families. They received an average of 30.6 h of family therapy supervision in the past year. They mainly see individuals and families with adolescents, and their approach is eclectic. This paper compares the findings in China with findings from North America, discusses possible reasons for differences in the findings, and provides suggestions for future development and studies of family therapy in China. [ABSTRACT FROM AUTHOR]

Many children are brought into therapy because parents view them as having a 'problem.' Children will often internalize these negative perspectives from others and create an identity based upon these notions. This paper presents a novel way for marriage and family therapists to integrate narrative and play therapy techniques for children and their families. It provides a model that is organized according to Erik Erikson's psychosocial stage theory to ensure that developmentally appropriate techniques are being utilized. During each stage, an example is provided for further clarification. [ABSTRACT FROM AUTHOR]

Research on individual therapy suggests that the ability to build effective therapeutic alliances with clients is related to the therapist's adult attachment style. This paper reports an on-line survey of the attachment styles of registered family therapists in the UK which investigated associations between therapist's attachment style, prior profession, gender and preference for a model of therapy. All 443 UK registered family therapists were surveyed and 82 (19 percent) replied. The survey included two standardised self-report measures: the Relationship Questionnaire (RQ) (Bartholomew and Horowitz in Pers Soc Psychol 61:226-244, ) and the Experiences in Close Relationships Questionnaire (ECR) (Brennan et al. in Attachment theory and close relationship. The Guilford Press, New York, ). The RQ invites respondents to rate the extent to which descriptions of secure, preoccupied, dismissing and fearful attachment styles applied to themselves. The ECR is a more conventional measure similar to a personality inventory. Responses to the two measures were discrepant. On the RQ 61 self-reported as having a 'secure' attachment style, nine 'preoccupied', six 'dismissing' and six were 'fearful'. Responses to the ECR indicated that 24 were 'secure', 16 'preoccupied', 15 'dismissing' and 27 'fearful'. Attachment style, as measured by the ECR, was not associated with therapists' prior profession, gender and preference for a model of therapy. The discrepancy between measures may be attributable to the more transparent RQ measure. Participants' responses may have been based on how they wanted others to view them or how they viewed themselves. These responses are challenged by the findings from the ECR which revealed apparently less desirable adult attachment styles in this sample. [ABSTRACT FROM AUTHOR]

This paper aims to provide an overview of the family therapy in mainland China, by analyzing its development, current situation and future directions. The authors argue that the history of family therapy can be understood as three stages: introductory stage from 1985 to 1994, 'blossoming' stage from 1995 to 2004, and 'fast growing' stage from 2005 to present. In every stage, we can see clear differences in each of the following fields: training (including training programs in universities and workshops held by companies or institutes), academics (including research articles, professional books and conferences), and general public environment (including media and policies). We also outline the development of China's first university system family therapy training program as an example and evidence of family therapy's significant present and future development in mainland China. Based on this, we highlight some points for future improvement in family therapy in mainland China, including developing indigenous theories and practice models, reinforcing training and research programs in university systems, and improving accreditation standard for all family therapists. [ABSTRACT FROM AUTHOR]

Marriage and family therapists grapple with the intersection of societal influence and African American clients' presenting problems. Questions include: what impact has the historical trauma of slavery had on African Americans and what are the clinical implications of this trauma? This paper reviews the literature on the various residual effects of slavery (RES) within the African American community. A case vignette and a broad discussion of therapeutic techniques will be used to highlight the clinical implications of RES. [ABSTRACT FROM AUTHOR]

This paper describes the process of change in attitudes of male social workers' towards themselves and towards their clients who are male perpetrators of partner violence (PV). The process reveals a reconstruction of the therapist's beliefs concerning key elements in their work related being, such as masculinity, aggression, perception of their clients and their own male identities. The sample includes 15 male social workers that worked with battering men in social services. Data collection was performed through semi-structured interviews. The therapists' process of questioning the popular and accepted demonization of violent men clarifies what differentiates them from their clients, but also opens an authentic pathway to examining similarities they share as men, without the need to be politically correct or to conform. The implications for practitioners working in batterers' intervention programs are addressed. [ABSTRACT FROM AUTHOR]

As family therapists increasingly practice in healthcare settings, they need to be aware of forthcoming changes in healthcare policy and the impact of these changes on their clinical work and the lives of their clients. In this paper, we provide a primer on healthcare policy for family therapists, which describes current and proposed changes in healthcare that will potentially revolutionize healthcare delivery for families. We describe three key initiatives: (1) Triple Aim; (2) the Accountable Care Organization; and (3) the Patient Centered Medical Home. We conclude with a discussion about future directions and healthcare policies that include families. [ABSTRACT FROM AUTHOR]

Five experienced clinical psychologists were interviewed about their strategies for maintaining boundaries in psychotherapy. The interviews were subjected to qualitative analysis using grounded theory techniques to develop a preliminary model of boundary maintenance. The central principle exhibited by the interviewees was maintaining a therapeutic relationship to facilitate client self care. Overall, the central principle was comprised of three main working strategies: (1) maintaining client boundaries to ensure a clear focus on client needs; (2) maintaining psychotherapist boundaries to protect effective practice; and (3) maintaining psychotherapy boundaries to facilitate client reflection, awareness, and assumption of responsibility. Each strategy included two or three distinct meaning categories, explicated in the paper. Implications for clinical work and future research are discussed. [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]

In this paper, five values-diversity, science, education, practice, and spirit-(a) are examined within the professional context of psychotherapy, (b) are presented as forming the foundation of much if not all that is psychotherapy, and (c) are considered as binding values that join us as a community of practicing, theorizing, and researching psychotherapists. Some of the positives of each value are reviewed. Diversity has heightened our sensitivity to and respect for individual and cultural differences. Science has kept us focused on empirically challenging and empirically informing our practice. Education has maintained emphasis on providing solid training/supervision in psychotherapy and transmitting its culture. Practice has provided us with opportunities to increasingly implement and expand on our role as helpers and healers. Spirit has been the guiding light-the heart and soul-that supports, infuses and informs all of our therapeutic endeavors and gives them meaning. What follows is a celebration of sorts-(a) capturing some of what we have done and are doing right in psychotherapy, (b) reflecting some of the weight of those 'right' efforts, and (c) conveying some of the inherent hope, promise, and possibility that forever guide us in our work. [ABSTRACT FROM AUTHOR]

In this paper the author, a psychotherapist specializing in bereavement, recounts her personal experiences of loss and the ways in which they intersect and inform her professional life. One clinical vignette explores how unresolved grief in a patient and anticipated grief in a therapist emerge in transference-counter-transference issues. Another vignette illustrates a way in which supportive therapy can open the door to intra-psychic work with the ill or dying patient and how psychoanalytically informed psychotherapy with the aged can help them to re-imagine their lives and to form different relationships, in their minds, with significant others in their past. [ABSTRACT FROM AUTHOR]