The Therapeutic Bond Scales: Psychometric Characteristics and Relationship to Treatment Effectiveness

The Therapeutic Bond Scales assess the quality of the therapeutic relationship from the patient\u27s perspective. The therapeutic bond is composed of 3 aspects: working alliance, empathic resonance, and mutual affirmation. Scales were developed to measure these aspects and the therapeutic bond as a whole. The correlations between these scales and 2 measures of outcome (session quality assessed by the patient and termination outcome evaluated by nonparticipant raters) were examined. All scales were significantly correlated with session quality. Therapeutic bond was significantly correlated with termination outcome in both a linear and a curvilinear fashion, suggesting that, at least in the initial phase of therapy, the therapeutic bond can be too high as well as too low

The personal self of psychotherapists : Dimensions, correlates, and relations with clients

ObjectiveThe personal self of psychotherapists, that is, experiences of self in close personal relationships and its association with therapists' individual and professional attributes is explored. The study aimed to: (a) describe therapists' self-ratings on specific self-attributes; (b) determine their dimensionality; (c) explore demographic, psychological, and professional correlates; and (d) assess the convergence with professional self. MethodData from the Development of Psychotherapists Common Core Questionnaire were available for>10,000 psychotherapists of various professions, theoretical orientations, career levels, and nations. ResultsMost psychotherapists described themselves in close relationships in affirming terms (e.g., warm/friendly), although a substantial minority also described themselves in negative terms. Factor analyses yielded four dimensions: Genial/Caring, Forceful/Exacting, Reclusive/Remote, and Ardent/Expressive. Being Genial/Caring was associated with life satisfaction. Among professional attributes, personal self-experiences, and parallel dimensions of relationship with clients correlated strongly. ConclusionsAnalyses of>10,000 psychotherapists revealed meaningful variations in personal self relevant to personal and professional life.Peer reviewe

Exploring influences of supervision on psychotherapists’ professional development: Correlates across career-level cohorts

This exploratory study aims to extend and strengthen the empirical case for supervision as a facilitator of professional growth, as outlined in an established conceptual model, by exploring its correlates among psychotherapists across their entire professional career. Ratings of the impact of supervision by 6267 psychotherapists of different professions, theoretical orientations, and career levels in many countries who were currently in supervision were correlated, separately for each of five career cohorts, with aspects of their treatment experience, work situation, and personal characteristics. Large percentages of psychotherapists at all career levels, including senior psychotherapists, engaged in supervision and rated its impact on their development positively. Growth-facilitating supervision was associated broadly but moderately in all career cohorts mainly with interpersonal aspects of therapists’ treatment experience, with supportive work settings, and with caring and expressive personal characteristics. Some differential findings among cohorts also reflected potential developmentally based functions of supervision. The implications of results were considered both for supervisory practice, training and for future supervision research

Paul E. Kahle y Federico Pérez Castro: los orígenes de la Escuela de Crítica Textual Bíblica de Madrid

We have frequently been asked about the origins of the Madrid School of Biblical Text Criticism. We have limited the content of this paper to Masoretic studies. Research into the files of the former Instituto Arias Montano of the CSIC disclosed a series of unedited letters between Professors Kahle and Pérez Castro; a paper by F. Pérez Castro and F. Cantera Burgos on “Prof. Paul E. Kahle y los estudios de crítica textual bíblica en España,” and a description by F. Pérez Castro of the first project to edit the Cairo Codex of the Prophets. Through these materials we can trace the main steps of the relationship between these two relevant scholars and the role that such a relationship played in the origin and late development of these studies in Madrid.A menudo se nos ha preguntado por los orígenes de la escuela de crítica textual bíblica de Madrid. Hemos limitado el contenido de este artículo a los estudios masoréticos. Investigando en los archivos del antiguo Instituto Arias Montano del CSIC hemos encontrado una colección de cartas inéditas entre los Profesores Kahle y Pérez Castro; un artículo escrito por F. Pérez Castro y F. Cantera Burgos titulado «Prof. Paul E. Kahle y los estudios de crítica textual bíblica en España», y la descripción hecha por Pérez Castro del primer proyecto para editar el Códice de Profetas de El Cairo. Gracias a estos testimonios hemos podido documentar las principales fases de la relación entre estos dos eminentes profesores y el papel que tal relación desempeñó en el origen y posterior desarrollo de estos estudios en Madrid

The professional development of counsellors and psychotherapists: Implications of empirical studies for supervision, training and practice

Background: This article presents key findings of two major empirical studies of psychotherapist and counsellor development. Both aimed to advance knowledge of variations in professional development and better understand the complexity of formative influences.Methodology: The Minnesota Study of Therapist and Counsellor Development and the International Study of Development of Psychotherapists (ISDP) combined qualitative and quantitative research.Results: In the “Minnesota study,” qualitative analysis of data from 100 psychotherapists (172 interviews) at different experience levels led to formulating five phases of practitioner development: the Novice Student Phase, Experienced Student Phase, Novice Professional Phase, Experienced Professional Phase and Senior Professional Phase. Results were integrated in a model describing three developmental trajectories—Continued development, Exhaustion and Disengagement—suggesting a developmentally sensitive approach to supervision. In the ISDP study, the Development of Psychotherapist Common Core Questionnaire was used to survey approximately 5,000 psychotherapists from countries throughout the world from 1991 to 2003 (currently about 12,000 therapists). Multi‐level quantitative analysis yielded two broad dimensions of therapeutic work experience, Healing Involvement and Stressful Involvement, based on therapists’ clinical skills, difficulties in practice, coping strategies, manner of relating to clients and in‐session feelings. Analysis of therapists’ experiences of current professional development showed two dimensions (Currently Experienced Growth and Currently Experienced Depletion). These were predicted, respectively, by Healing Involvement and Stressful Involvement and in turn predicted different levels of Overall Career Development.Implications: Implications for supervison were drawn from the findings of The Phase Model and the Cyclical Trajectories model of the Minnesota‐study, while the ISDP study results were integrated in a Cyclical‐Sequential Model with implications for clinical training, supervision and practice

Motivation as a predictor of outcomes in school-based humanistic counselling

Recent years have seen a growth in the provision of counselling within UK secondary schools, and research indicates that it is associated with significant reductions in psychological distress. However, little is known about the moderators and mediators of positive therapeutic benefit. In the field of adult mental health, motivation has been found to be one of the strongest predictors of therapeutic outcomes, and it was hypothesised that this may also be a predictor of outcomes for young people in school-based counselling services. To assess the relationship between young people’s motivation for counselling and its effectiveness within a secondary school setting. Eighty-one young people (12 - 17 years old) who attended school-based humanistic counselling services in Scotland. Clients completed a measure of motivation for counselling at the commencement of their therapeutic work and a measure of psychological wellbeing at the commencement and termination of counselling. Motivation for counselling was not found to be significantly related to outcomes. The results indicate that the association between motivation and outcomes may be weaker in young people as compared with adults. However, a number of design factors may also account for the non-significant findings: insufficient participants, marginal reliability of the motivation measure and social desirability effects

Clients’ experiences of one-to-one low-intensity interventions for common mental health problems : an interpretative phenomenological analysis

Objectives: Common mental health disorders such as depression and anxiety are highly prevalent and carry significant health care and economic burdens. The UK’s improving access to psychological therapies (IAPT) initiative was developed as a cost-effective way of reducing the pernicious effects of these disorders. IAPT interventions, such as guided self-help, have been subjected to considerable quantitative evaluation. However, there has been minimal investigation into clients’ experiences of the one-to-one low-intensity interventions (LIIs), which form a key component of IAPT service provision. Qualitative exploration could provide rich data regarding experiences of psychological change and factors affecting therapeutic experiences. This will enable informative, client led insights into how low-intensity therapy can be improved. Methods: Interpretative phenomenological analysis of eight semi-structured interviews was used to develop an idiosyncratic understanding of clients’ experiences of one-to-one LIIs following entry into a randomized control trial (RCT). Results: Four superordinate themes were identified from clients’ accounts: goals and expectations of therapy, beneficial aspects of therapy, non-beneficial aspects of therapy, and the experience of psychological change. A heuristic model of interrelationships between factors is proposed. Conclusions: Both therapeutic techniques and relationships contribute to beneficial therapeutic experiences. The results reported here can be used to inform practice by harnessing the most beneficial aspects of therapy, such as developing adaptive therapeutic approaches to clients’ clinical needs and facilitating idiosyncratic processes of psychological change. Due to limited qualitative research in this area, further research should be conducted in different service settings to assess differences and similarities in clients’ experiences

An exploration into the client at the heart of therapy : a qualitative perspective

Over 50 years ago Eysenck challenged the existing base of research into psychotherapy. Since that time, a large number of investigations have been conducted to verify the efficacy of therapy. Recently however, an increasing number of studies have cast new doubts on this research base. Instead of therapy being a function of the therapist, it is now becoming ever more apparent that the client plays a prime role in the therapeutic process. The qualitative studies presented in this paper provide some examples of research that demonstrates that clients are actively involved in their therapy, even making counselling work despite their counsellor. These studies suggest that clients may not experience therapy as beneficially as traditional outcome studies indicate. This raises a new challenge to researchers to more fully explore the client's experience of therapy, a challenge to which qualitative methods of inquiry would appear well suited

Interactional positioning and narrative self-construction in the first session of psychodynamic-interpersonal psychotherapy

The purpose of this study is to identify possible session one indicators of end of treatment psychotherapy outcome using the framework of three types of interactional positioning; client’s self-positioning, client’s positioning between narrated self and different partners, and the positioning between client and therapist. Three successful cases of 8-session psychodynamic-interpersonal (PI) therapy were selected on the basis of client Beck Depression Inventory scores. One unsuccessful case was also selected against which identified patterns could be tested. The successful clients were more descriptive about their problems and demonstrated active rapport-building, while the therapist used positionings expressed by the client in order to explore the positionings developed between them during therapy. The unsuccessful case was characterized by lack of positive self-comment, minimization of agentic self-capacity, and empathy-disrupting narrative confusions. We conclude that the theory of interactional positioning has been useful in identifying patterns worth exploring as early indicators of success in PI therapy

Healing involvement and stressful involvement experienced by psychotherapy trainees: Patterns, correlates and perceived development

Background and Method: The experiences of 454 psychotherapy trainees when providing therapy to patients were surveyed in a multinational sample largely from European countries, as part of the collaborative SPRISTAD study, using established measures of trainees' Healing Involvement (HI) and Stressful Involvement (SI). Results: The results of cross-sectional analyses included the delineation of four differential patterns of therapeutic work involvement showing approximately half the trainees experienced an Effective Practice (high HI, low SI) while the other half experienced either a Challenging Practice (high HI, high SI), a Disengaged Practice (low HI, low SI) or a Distressing Practice (low HI, high SI). Discussion: Strong-to-moderate correlations were found between involvement styles and trainees' individual personal and professional characteristics, and among training programme and workplace situational conditions, and their possible applications to candidate selection and training practices were discussed. A strong association was seen between HI and SI qualities of trainees' therapeutic work and their positive or negative experiences of current professional development. Implications for training and hypotheses for future longitudinal studies were proposed based on the results.</p