Processing the Therapeutic Relationship

The authors propose that if therapists and clients process their therapeutic relationship (i.e., directly address in the here and now feelings about each other and about the inevitable problems that emerge in the therapy relationship), feelings will be expressed and accepted, problems will be resolved, the relationship will be enhanced, and clients will transfer their learning to other relationships outside of therapy. The authors review theories supporting the idea of processing the therapeutic relationship, discuss the relevant empirical literature in this area, and provide their conceptualization of the construct of processing the therapeutic relationship based on the theory and empirical findings. Finally, they discuss methodological concerns and suggest implications for clinical practice, training, and further research

Self-Disclosure

A review of the analog literature about therapist self-disclosure suggests that nonclients generally have positive perceptions of therapist self-disclosures. A review of the naturalistic psychotherapy literature indicates that therapist self-disclosure occurs infrequently, is used more often by humanistic-experiential than psychoanalytic therapists, is most often about professional background than about intimate personal details, is used for many different reasons, is used cautiously by therapists, and is helpful in the immediate process of therapy. Effects of therapist self-disclosure on the ultimate outcome of therapy are less clear. Limitations of the research (poor and inconsistent definitions and lack of a clinically appropriate methodology for studying self-disclosure) and guidelines for therapeutic practice are presented

Introduction to a Special Issue on Disclosure and Concealment in Psychotherapy

Given that questions related to disclosure have long held the interest of both clinicians and researchers, we are excited to present this special issue of Counselling Psychology Quarterly focusing on disclosure and concealment in psychotherapy. All forms of human communication involve some degree of disclosure, whether through verbal or non-verbal means. Most of us are quite careful about both the content and quantity of what we share with others. One factor that affects decisions about disclosure is the type of relationship. Friendships typically include an approximately equal amount of disclosure from both members, whereas in other relationships (e.g. parent–child, boss–employee), disclosure patterns may be less equal. Psychotherapy is one such relationship where participants likely do not disclose equally. Clients are expected to reveal themselves as much as possible so that therapists can help them, although the depth of such disclosures may gradually evolve as clients begin to feel safe with their therapists. In contrast, given that the purpose of psychotherapy is to help the client, therapist self-disclosure (TSD) is usually much more limited and ideally used only to help the client rather than meet therapists’ needs. Because psychotherapy is on the one hand much like a friendship, given the level of intimacy and sharing (Schofield, 1986), yet on the other hand a professional relationship focused on the client, it offers a rich opportunity for examining the disclosure process. We can consider disclosure to exist on a continuum. At one extreme, nothing is withheld and the person is completely open with all conscious thoughts and feelings. At the other extreme, a person does not disclose at all and in fact, might be actively concealing or lying. Few people live at the extremes, as it is almost impossible either to share or withhold all thoughts and feelings. In addition, it is important to recognize that disclosure is a state rather than a trait, such that although one may be generally open, that same person might not disclose in a particular given situation. For this special section, then, we focus on several aspects of this disclosure continuum. First, we focus on TSD. Next, we focus on client disclosure and concealment. We refer readers to prior reviews of the literature to gain more perspective on past research in this area (Henretty, Berman, Currier, & Levitt, 2014; Henretty & Levitt, 2010; Hill & Knox, 2002; Knox & Hill, 2003)

The Use of Dreams in Modern Psychotherapy

We review theories of dream work. We also review the empirical research about how dreams are used in psychotherapy, as well as the process and outcome of different models of dream work. Finally, we review how dream content can be used to understand client, the role of culture in dream work, client and therapist dreams about each other, and training therapists to do dream work

Teaching Graduate Trainees How to Manage Client Anger: a Comparison of Three Types of Training

The authors examined the effects of three types of training (supervisor-facilitated training, self-training, biblio-training) on 62 graduate student therapists\u27 state anxiety, self-efficacy for dealing with anger, and helping skills (i.e., reflections and immediacy) in response to videotaped vignettes of angry clients. Training overall was rated as very helpful, and trainees increased in self-efficacy for working with client anger. Supervisor-facilitated training was rated as more helpful than, and was preferred to, self-training and biblio-training; it also led to more reflection of feelings in response to clients. Results suggest that vignettes such as these might be a helpful adjunct to training once students have competency in the basic helping skills

Supervisor Self-disclosure: Supervisees\u27 Experiences and Perspectives

Twelve graduate-level supervisees were interviewed regarding their experiences of supervisor self-disclosure (SRSD); data were analyzed using consensual qualitative research. When describing a specific SRSD experience, supervisees reported a range of antecedents (e.g., difficult clinical situation, self-doubt, tension in supervision relationship) followed by supervisor disclosures about clinical experiences or personal information. Supervisees perceived that their supervisors disclosed primarily to normalize, but also to build rapport and to instruct. The SRSDs had mostly positive effects (e.g., normalization), though some negative effects (e.g., deleterious impact on supervision relationship) were reported. Implications of these findings for supervision, training, and research are addressed

Becoming Psychotherapists: Experiences of Novice Trainees in a Beginning Graduate Class

The authors investigated the experiences related to becoming psychotherapists for 5 counseling psychology doctoral trainees in their first prepracticum course. Qualitative analyses of weekly journals indicated that trainees discussed challenges related to becoming psychotherapists (e.g., being self-critical, having troubling reactions to clients, learning to use helping skills), gains made during the semester related to becoming psychotherapists (e.g., using helping skills more effectively, becoming less self-critical, being able to connect with clients), as well as experiences in supervision and activities that helped them cope with their anxieties. Results are discussed in 5 broad areas: feelings about self in role of psychotherapist, awareness of reactions to clients, learning and using helping skills, reactions to supervision, and experiences that fostered growth. Implications for training and research are provided

A Qualitative Examination of Graduate Advising Relationships: The Advisor Perspective

Nineteen counseling psychology faculty members were interviewed regarding their advising relationships with doctoral students. Advisors informally learned to advise from their experiences with their advisor and their advisees and defined their role as supporting and advocating for advisees as they navigated their doctoral program. Advisors identified personal satisfaction as a benefit and time demands as a cost of advising. Good advising relationships were facilitated by advisees’ positive personal or professional characteristics, mutual respect, open communication, similarity in career path between advisor and advisee, and lack of conflict. Difficult relationships were affected by advisees’ negative personal or professional characteristics, lack of respect, research struggles, communication problems, advisors feeling ineffective working with advisees, disruption or rupture of the relationship, and conflict avoidance. Implications for research and training are discussed

Case Studies of the Attainment of Insight in Dream Sessions: Replication and Extension

To replicate and extend the Hill, Knox, et al. (2007) case study of a client who attained insight in one session of dream work, the authors examined two additional single-session cases: one in which a client gained insight and another in which a client did not. The observations across all three cases suggest that the two clients who acquired insight had positive attitudes toward dreams; were motivated and involved in session; and were nonresistant, trusting, and affectively present but not overwhelmed. The client who did not gain insight questioned the value of dreams and was resistant, untrusting, andf emotionally overwhelmed. Therapist adherence and competence using the dream model, ability to manage countertransference, and effective use of probes for insight distinguished the therapists whose clients gained insight from the therapist whose client did not