Self psychology and countertransference in the treatment of children

The issues of countertransference in the treatment of children have received far less attention than those arising in the treatment of adults. This paper attempts to begin to redress this imbalance. Some of the major countertransferences in work with children are addressed, and the perspective of self psychology is presented. In the conclusion some thoughts are offered regarding some of the narcissistic injuries therapists must confront in dealing with issues of countertransference.     

Out from under: Countertransference in the treatment of the masochistic youngster

The masochistic youngster tends to evoke in the treatment situation precisely the responses which impede progress. This article discusses countertransference issues and the dynamics of masochism, understood as a protection for a frightened ego rather than merely a willful manipulation. Difficulties in and approaches to dealing with the environment of children in residential treatment are presented.Ms. Smaldino is currently in private practice and supervisor of psychotherapy for the New Hope Guild.     

Family Phone Therapy in University Counseling and Psychological Service Centers: A Family Systems Approach

Abstract

This paper offers family phone therapy as a method for student mental health practitioners to overcome the obstacle of geographic distance between students and their families when family therapy is the treatment of choice. The issues of confidentiality, triangulation, diversionary conversation, and mixed communication, which present unique concerns when engaging in family phone therapy, are introduced and strategies to deal with them are discussed. A case example is presented to demonstrate the utility of family phone therapy in dealing with problems that students who use university mental health services can typically experience. Finally, implications of dealing with students' developmental tasks from an individual or family systems perspective are discussed.     

Legal issues surrounding psychotherapy with minor clients

This article discusses several legal issues of concern to psychotherapists working with minor clients such as informed consent to treatment, confidentiality, and the minor's legal capacity to enter the psychotherapist-client relationship. Suggestions are offered to assist the clinician in dealing with these legal issues.     

Introduction: assessment and treatment of youth who sexually offend: an overview

This introductory article provides an overview of the significant issues involved when dealing with youth who sexually offend, sometimes referred to as juvenile sex offenders or sexually reactive children or adolescents. There is not an accepted term or definition that is widely used to describe or refer to this population, and the precise prevalence or incidence rates are not known. Statistics are presented from various national studies, but methodological problems in the research are also noted. The authors briefly discuss the current research concerning youth who sexually offend, present some of the important issues in this area of research and practice, and list various types of sexual victimization that have been included when dealing with youth who sexually offend. The article then introduces the current volume, describing the articles and content. Identifying and treating youth who sexually offend is in its infancy in many ways. It is hoped that this volume will provide important information to help those in research and practice better understand the issues and dynamics of this population.     

Understanding the "what should be condition" in needs assessment data

In needs assessment (N/A), the calculation of discrepancies is based on the assumption the “what should be” condition is a reasonable representation of respondent perceptions. That assumption may be erroneous and requires a closer inspection. This paper examines the use of importance scores in NA and some of the problems that can arise when they are used as a proxy to measure the “what should be” condition. A review of the literature and ways of dealing with importance scores are presented, followed by a discussion of the problems and issues that can arise. Some solution strategies are offered along with recommendations for practice and research. The paper provides guidance for others interested in improving needs assessment procedures.     

Intimacy Is Sharing Hurt Feelings: A Comparison of Three Conflict Resolution Models

To check on the validity of three different methods of dealing with anger, 1) calm, rational discussion, 2) "fair fighting," and 3) sharing of hurt and of fear of hurt, two different studies were performed. In the first study a video-taped procedure was presented to 36 undergraduates. Their preferences indicated no support for the hypothesis of sex differences in dealing with conflict and some support to differential preferences for each of three methods. In the second study, three structured programs directly derived from the three theoretical positions were administered at random to 11 couples. Their reactions suggested some support for the position that intimacy may be found in sharing of hurt feelings. Theoretical issues and directions for future research are considered.     

Racial/Ethnic Intermarried Couples and Marital Interaction: Marital Issues and Problem Solving

Abstract

Throughout history interracial/interethnic marriages have been considered an extreme deviation from the marital norm and thus inappropriate by the standards of mainstream society and minority communities. Even today, societal views of intermarried couples often remain negative in nature. This negative perception is frequently sustained by the assumption that intermarried couples experience race / ethnic-based differences in social, moral, and living standards that result in marriages that are fraught with conflict and instability. The mate selection literature however, would suggest that intermarried couples are not socially deficient, but are similar to those who marry within their racial / ethnic group. This research is intended to fill a gap in the literature by exploring the interpersonal, interactive aspects of interracial/interethnic marriages. In particular, this study evaluates intermarried couples as they interact during videotaped sessions of cooperative problem solving to determine if they are similar to, or distinct from, intramarried couples. Data from two aspects of the marital interaction are presented: the types of marital problems encountered and the manner in which couples attempt to resolve these issues. Findings show that while race/ethnicity did not emerge as an issue for intermarried couples, they were confronting different marital issues than intramarried couples. In addition, intermarrieds often employ different interactional styles than intramarrieds when dealing with their marital issues.     

Some Questions for Linda Mitchel on Loss and Bereavement

Resolving loss is the theme of this issue's interview. Linda Mitchell offers something in her employee counseling services that more employee assistance specialists need to address - helping clients better understand and resolve the sense of loss. She is a skilled psychotherapist with a specialty in counseling on "loss-related issues." She has designed and conducted support groups dealing with issues such as bereavement, self-esteem, job loss. As a skilled psychotherapist she has provided counseling and education to families experiencing a death of a loved one. In addition to seeing chemically dependent clients in her practice, she has experience counseling people with AIDS. Another part of her practice a assisting individuals in dealing with various life issues such as a change in a job position, or the loss of employment.     

“I AM STILL SUFFERING:” THE DILEMMA OF MULTIPLE RECOVERIES IN THE LIVES OF METHADONE MAINTENANCE PATIENTS

This study examines narratives on the meaning of addiction recovery through interviews with 45 methadone maintenance treatment (MMT) patients. Results show that heroin addicts are dealing with multiple recoveries and many are simultaneous to each other: recoveries concerning (1) addiction, (2) associational disruptions, (3) self-identity and actualization, (4) drug induced diseases (HIV/AIDS, HCV, etc.), and (5) catalyzing event(s). The research findings, anathema of clinical MMT views on recovery, suggest that drug addicted individuals might benefit from interventions that address their multiple recovery issues as opposed to ones that emphasize recovery strictly in sobriety terms.     

The impact of therapist pregnancy on the treatment process

Therapist pregnancy is a powerful emotional stimulus and a real-life event that affects clients and the treatment process. In the present paper, previous literature is reviewed and clinical experiences of the author in a university counseling center are reported to address how therapist pregnancy influences clinical treatment. Although therapists often hesitate in emphasizing their pregnancy, evidence suggests that it is easy to underestimate the importance of the pregnancy for clients. Case examples are presented which demonstrate client responses and the significance of the pregnancy for four female clients. Gender differences in client reactions are not fully understood, and it may be particularly difficult to facilitate male clients in dealing with issues stimulated by the pregnancy. These clinical findings suggest that in a variety of settings, understanding and working with clients' reactions to the therapist's pregnancy can enhance treatment.     

Working with Contact Father Families: Insights from Therapy

The incidence of marital and relationship breakdown, in particular where children are involved, continues to increase across Australia. For the contact father, the psychological and emotional effects of separation are often experienced concurrently with many practical matters and can raise issues such as dealing with loss, identity development and constructive role restructuring. The adjustment period can also expose an increasing need to move on in developmental terms. This paper describes the effects of relationship or marital breakdown and ongoing adjustment issues upon those contact fathers who have not initiated separation, who have physically left the family home and in doing so, have left their children behind with the mother. The paper also considers the psychological and therapeutic implications for working with this often marginalised group of clients. A working model which addresses various coping styles is presented.     

Mixed-Methods-Sampling als Mittel zur Abgrenzung eines unscharfen und heterogenen Forschungsfeldes

Problems in defining the research field and in generalizing emerge in both quantitative and qualitative research. With the analysis of “fears of the future in dystopian feature films”, a multi-stage sampling strategy is presented to point out these difficulties as well as to illustrate one possible way of dealing with them. Particularly, in heterogeneous, rapidly changing and diffuse fields of research conducting mixed-method-studies can compensate for the weaknesses of quantitative and qualitative research logics. Therefore, further research should address issues of field delineation, sampling and generalization in greater detail.     

If I Am Not Straight or Gay,Who Am I?

Women that are violating heterosexual norms for sexual desire will run into issues about identity. This study explores ways of dealing with sexual identities that seems to provide a workable solution for women when they navigate and negotiate their lives as lesbians in a society dominated by heterosexual norms. The data sources are therapeutic conversations and followed-up interviews with ten women. The stories told by these women fail to fit the phases and the categorizations of the traditional coming out model. In handling dilemmas, ambiguity seems to be a resource to them. Their efforts and solutions are more in accordance with queer theory, when they navigate between dichotomies of homosexual/heterosexual, feminine/masculine, normality/deviance and personal responsibility/coincidence.     

Stars are not Born: An Interpretive Approach to the Politics of Disability

The politics of disability are usually interpreted as attempts to influence government policy in the direction of reducing the negative effects of impairment. This paper enlarges that conventional notion to include attention to how the disabled subject is produced by the discursive practices within which disability is administered.

A summary of epistemological perspectives represented by contemporary social thought dealing with disability opens the discussion. Foucault's work is presented as the basis for interpreting recent social science literature on disability from a viewpoint which is sensitive to variations in epistemological presuppositions in that literature and to the political implications of each mode of research for the administration and treatment of disability.

A concluding section contains speculation on forms of political action which are relevant to the politics of disability at the constitutive level.     

Issues of Isolation and Intimacy for the HIV Infected,Sexually Addicted Gay Male in Group Psychotherapy

The pertinent issues of isolation and intimacy with sexually addicted, HIV infected gay males was researched from the perspective of group psychotherapy as a treatment modality. The purpose of the article was to highlight shame based feelings associated with being sexually addicted and HIV diagnosed with the subsequent behaviors of isolation and difficulties with intimacy. The group model is examined as a means towards alleviating isolation and helping the client form new ways towards bonding and forming intimacy. Group interventions are seen to be helpful in lessening sexual compulsivity, creating new forms of relating and providing a safe environment for an individual dealing with HIV disease.     

Evaluating Decisionmaking Capacity in the Elderly:

This article critically reviews and analyzes recent contributions to the medical and legal literature dealing with the subject of defining and assessing decisionmaking capacity in older patients/clients. The themes and issues set forth in this burgeoning literature are described and guideliens are commented upon in terms of their usefulness to practitioneres and the ethical and social policy implications they raise.     

Dual Relationships: The Challenges for Social Workers in Recovery

ABSTRACT

Over the last ten years there is increasing focus in social work literature about non-sexual dual relationships. This has included consideration of different types of dual relationships that occur primarily during or after the establishment of professional social worker-client relationship. However, the specific concerns facing social workers who are themselves in recovery from substance use disorders remain absent from these discussions. This article identifies challenges facing social workers in recovery from substance use disorders who also work with clients dealing with these disorders. Recommended actions and policies that can assist professionals and agencies in balancing personal and practice issues are presented.     

Working With Families Within Inpatient Settings

This paper examines the family's experience of psychiatric hospitalization. It considers the ways in which the family therapist can help keep the family system intact and involve it in the inpatient treatment process. Family-related and hospital-related obstacles to family involvement are discussed, along with suggestions for dealing with them. Also presented are family problems characteristic of an adult hospitalization population and suggested treatment strategies .     

THERAPEUTIC INTERVENTIONS IN LIFE-THREATENING SITUATIONS*

Therapists who encounter life-threatening behavior in their clinical practice are at risk in providing interventions which do not take into account the systemic effects of their interventions. Specifically, therapists are likely to engage in “more of the same” behavior with clients who present with suicidal or homicidal threats. This paper presents two case studies that employed therapeutic methods derived from the systemic therapy of the Palo Alto group. In these case studies, the author illustrates the importance of the therapist's ability to speak the client's language in formulating an intervention that has the potential for reducing the likelihood of actual violence. The first case illustrates the use of the client's world view about her situation to assist her in dealing with domestic violence. The second case presented describes the use of systemic interventions in the case of a young woman known to have made homicidal threats. The author discusses the appropriateness, as well as the ethical issues, of the techniques described. Also offered, is a discussion clarifying the theoretical underpinnings of the clinical work presented and an amplification of some of the ideas originally presented by the Palo Alto group.