South Australia's First Family Therapist — Jeff Gerrard Remembers: An Interview

Jeff Gerrard can claim the distinction of being the first family therapist in South Australia. Early on in his career as a psychiatrist he explored the growing field of psychotherapy overseas and observed, studied, and trained with some of the historical greats in the area. When he returned to South Australia in the early 70s, it seems to have been a natural step for him to begin practising family therapy and training other health professionals in the theory and practice of family therapy. The early training that Jeff led at the South Australian Children's Hospital enabled a cooperation between a number of early family therapists, such as Michael White and Anne Sved Williams, to train the first cohort of people who would later go on to become significant contributors to the family therapy field in Australia. In this interview, Lorraine Read invites Jeff to explore his early contributions to the field and to discuss the training and supervision experiences which were/are important in his development as a family therapist.     

A CHILD PSYCHOTHERAPIST IN PRIMARY MENTAL HEALTH

This paper outlines the author's application of psychodynamic thinking and approaches to brief therapeutic work with children, adolescents and their families in community mental health settings. It is the author's belief that systemic and narrative therapy insights and techniques combine well with psychoanalysis in the assessment and treatment of many concerns felt and expressed by parents and young people. The therapist's tasks are to listen empathically to clients who are in distress and to explore the clients' beliefs about the origins of their problems, as well as their previously attempted solutions. In proceeding at the family's pace, opportunities arise for facilitating more effective ways of resolving conflict. Clients are often more free than they realise to change their interpretation of their experience, and this has important consequences for the maintenance and solution of problems. Brief therapy seeks to remind clients of their strengths and resources and to share ways to encourage clients to resume effective ways of learning about themselves.     

Psychotherapy with Lesbian and Gay Clients from an Adult Life Course Perspective

Abstract

A life course perspective of gay and lesbian adulthood enriches our understanding of clinical presentations and modifies our conception of psychotherapy. The author describes shifts in his psychotherapeutic orientation characterized by an increasing recognition of the importance of social, cultural, and historical forces that shape gay and lesbian mental health. Given the uncharted nature of many gay and lesbian lives across adulthood, existential questions about the meaning of life choices are often present in the consulting room. Therapists working with gay and lesbian clients embark on an empathic journey informed by treatment skills as well as our joint participation in a world of significant social change.     

Memory and meaning in the psychotherapy of the long-term mentally ill

After a long period when the treatment of major mental illness was under the decisive influence of the biological revolution in psychiatry, there are now growing signs of a revival of the role of psychotherapy in understanding the lived experience of psychotic disorders. Despite increased attention to the subjective world of persons afflicted with severe mental illness, considerably less has been written about the devastating effects of a loss of reality on memory and meaning and about the especially complex ordeals facing therapists who enter into long-term relationships with clients cut off from the past and the future. The ensuing quest for meaning amid the breakdown of memory is the focus of this paper.     

Cyber Counseling for Queer Clients and Clinicians

Abstract

As the Internet grows, so does its use by mental health professionals and by clients seeking mental health services. Drawing on his own experience as an example, the author describes how the Internet can enhance clinical practice. Social service professionals can utilize the Internet to provide a supportive forum for patients grappling with issues of self-identity; facilitate communication between therapist and client; provide community education about mental health issues; provide referrals to local social service professionals; market a private psychotherapy practice; and provide patient billing, scheduling, and record keeping.     

Therapeutic Musings: The Models Which Contribute to My Practice

The author attempts to discern themes underlying his clinical practice. Although his approach is somewhat behaviourist in orientation, it is hoped that the 12 themes (or organising principles) can be compared and contrasted with those arising from other approaches to child, adolescent, and family work. The author invites readers to analyse the way they have pieced together a composite approach from a range of sources.     

Activism and the academy: losing the ideological and material battles

Abstract

In this article written in the summer of 2018 Professor Michael Oliver sought to convey a sense of urgency about the need to reinvigorate the relationship between disability, the academy and activism. In his usual clear unswerving style that is both liberating and enabling in its directness he calls upon all engaged with the journal to remember that the foundations of disability studies emerged out of democratic organisations of disabled people and must remain committed to placing the experiences of disabled people at the centre of academic and activist enterprise. He places emphasis on the original purpose of the journal to build on the social model of disability in order to produce real social change expressing frustration about what he saw as an increasing ineffectualness within the academic community to confront what is really happening to disabled people. He is forthright when describing his hope that disability activists and academics will strengthen the future of disabled people, and the future of disability studies too, by working ever more closely together.     

Beginning Practice with Preoperative Male-to-Female Transgender Clients

Abstract

Preoperative male-to-female transgender clients often present with specific and unique psychological and social issues distinct from gay male and lesbian clients. Therapists must be ready to assess and help diagnose these in preparation for work with gender queer clients. Therapists must also be prepared to face and resolve the various counter-transference dynamics inherent in therapeutic relationships with transgendered individuals. This Practice Note focuses on the author's beginning clinical and social case management experience working with two preoperative male-to-female transgender individuals.     

‘Somebody Watching You’: Impact of Reflecting Teams on Hope in Couple Relationships

Reflecting teams (RTs) represent both an epistemological stance and a therapeutic technique. Most commonly associated with narrative and systemic approaches to therapy, RTs offer an outsider perspective that can bring hope and alternative narratives and perspectives for therapists and clients to explore. Relational hope is a little researched concept in the field of couple therapy research. This study explores the experience of RTs in couple relationships and the aspects of the experience that couples describe as connected to a sense of hope for their relationship. The study also considers whether difference in attachment style shows any relationship with hope in couple relationships before and after the clients’ session with a reflecting team. Couples completed questionnaires about their attachment style, demographics, and relational hope and were given the option to complete an interview about their experience with the reflecting team within 1 month of their therapy session. Our findings suggest that RTs contribute positively to hope in couple relationships particularly for clients who present with an anxious attachment style. This direction for research is important because there is very little research about hope in couple relationships despite its importance (Merolla, 2014; Snyder, 2002) and there is no research about what aspects of a reflecting team contribute to hope in couple relationships. Analysis of interviews indicates a number of features of the reflecting team feedback that were valued by clients.     

Training Mental Health Professionals in Child Sexual Abuse: Curricular Guidelines

This study explored whether counseling practices with women survivors of child sexual abuse reflect the belief that women do not sexually abuse children. Canadian therapists (n?=?164) who work with women survivors of child sexual abuse were surveyed about their beliefs about what constitutes child sexual abuse, who commits child sexual abuse, and their practices regarding inquiries about abusive behavior. A majority self-reported that they ask women and think it is important to ask but most believe that clients will not spontaneously self-disclose inappropriate sexual thoughts or behaviors. How broadly or narrowly therapists defined child sexual abuse was not related to self-reported therapeutic discussion. Therapists demonstrated differential gender beliefs about child sexual abuse perpetration, but this did not relate to self-reported counseling practices. Implications for therapist education are discussed.     

„Unkündbar und nun?“ Lebensziel oder Schicksalsschlag – Chancen für eine faire Trennungskultur in der öffentlichen Verwaltung

Job security is seen as a very high value by employees regarding their professional objectives. Especially for employees in public service that secure professional status is one of their main reasons for working in public servance. Therefore, any dismissal may have severe negative effects on health of the employees and also negative effects on the image of the employer. From their perspective, an outplacement program could be an expedient element within the employee-life-cycle (recruiting—retention—exit/outplacement). A fair culture of separation in the organizational context in public sector which is accompanied by an outplacement program can give new perspectives to the employees and strengthen the image of the employer. An interview study with clients of an outplacement consultation will be mentioned. The participants were asked about their expectations and experiences with the consultation. Basically, the results clearly show that the consultant has a tremendous importance and is thus one of the most important success factors. If he or she meets the needs of the client, he or she works up the separation and promotes the confidence of his clients, nothing stands in the way of a successful consultation.     

Effect of Brief Staff‐Assisted Career Service Delivery on Drop‐In Clients

Brief staff‐assisted career counseling services based on cognitive information processing theory were evaluated using 138 drop‐in clients who completed pre‐ and postintervention self‐report measures of knowledge about next steps, confidence in making next steps, and anxiety about career concerns. Significant changes occurred in each dimension and were significantly associated with the quality of career adviser interaction. Participants rated the experience as highly positive. Decreases in anxiety about career concerns were unrelated to the intervention. Implications include that a brief service delivery model yields positive outcomes for many clients but requires adjustments in organizational culture, physical environment, practitioner approaches, and client expectations. Future research should examine relational variables related to decreased anxiety with a brief service delivery model, the degree to which this approach works with specific career needs, and client attributes leading to successful versus unsuccessful outcomes with this model.     

Counseling Support for the Forgotten Transgender Community

The needs of people with nonconforming gender behavior are not homogeneous, for people who self-identify as transgender are not and should not be considered the same as individuals who self-identify as transsexual. Limited counseling resources are available for clinicians working with individuals who self-identify as transgender but have no desire to proceed to sexual reassignment surgery (SRS). Though it appears many of the recommendations for transsexuals are relevant for the broader range of transgender individuals, significant differences exist between them, warranting further investigation. This article presents a summary of approaches for gender-variant clients not matching the transsexual paradigm.     

Clinicians Play with Mud,and It's the Best Thing for Us: An Interview With Alistair Campbell

Alistair Campbell is Research Editor for the ANZJFT. He is a Senior Lecturer in Clinical Psychology and Director of the Psychology Clinic at James Cook University in Townsville. He speaks provocatively with Ben Hansen about research and training in family therapy, about accountability to our clients, and about practice.     

Integrating Dream Analysis with Intersubjectivity in Group Psychotherapy

The author discusses her application of Daniel Stern's theories of intersubjectivity to group psychotherapy. The group members were women presenting with issues regarding childhood molestation and/or abuse. From her case notes, she examines the dreams the women discussed in the group treatment setting and illustrates how the group members mutually constructed life narratives, which ultimately created new meanings regarding their lives. Through mutual construction of these narratives, her clients ultimately organized new senses of self, affecting them both interpersonally and intrapsychically.     

Some Clinical Applications of Attachment Theory in Adult Psychotherapy

This paper discusses the usefulness of attachment theory in working with adults in psychotherapy. There are four classifications of attachment status in adults: secure attachment, and three types of insecure attachment: dismissing, preoccupied, and disorganized. These categories do not conform to standard diagnostic entities. I discuss examples of the three insecure attachment categories and the likely transference and countertransference configurations that may occur in each category. These categories provide an additional way for therapists to understand and to respond to the needs of their clients.     

Dual-Career Marriages: Implications for the Clinician*

This paper discusses the unique characteristics of dual-career marriages/families. These familial units are identified as a high stress group presenting unusual challenges to the clinician. Specific implications for the clinician include (1) values of therapist and clients; (2) critical issues; and (3) assets and liabilities. It is concluded that while dual-career couples may be demanding clients, the therapist can be sure he/she will have an intriguing, eventful, and meaningful experience along the way.     

Mistakes That Let The Light In

A highly intelligent psychopath is not easily identified, and counsellors can fall victim to their manipulations unless aware of the characteristics by which psychopaths can be identified and to the feelings and sensations that they provoke. When working individually with clients, engaging other family members may be a necessary safeguard against clinical manipulation and its undesirable consequences.     

Health Care Professionals' Experience,Knowledge, and Attitudes Concerning Homosexuality

The purpose of this study was to examine the experience with attitudes towards, and knowledge about homosexuality of three groups of health care professionals. Subjects were 97 registeres nurses, social workers, and psychologists who responded to a six-page mailed questionnaire. Professional discipline of the subject, gender of the client, and gender of the client's lover in a fictitious scenario did not significantly affect ratings or suggested diagnoses of the client. Most subjects felt that they needed moer training in working with homosexual clients, which was consistent with their high but not perfect scores on a knowledge test. Subject's mean scores of the Attitudes Toward Lesbians (ATL) and Gay Men (ATGM) scales of Herek (1998) reflected significantly less prejudice than his college samples. More knowledgeable respondents were less prejudiced and had more positive attitudes about working with gay and lesbian clients; those with more positive attitudes toward clients also showed less prejudice on the ATL and ATGM scales. The authors argue that training health care professionals to be more knowledgeable about gay and lesbian issues would lead to more positive attitudes and better services for gay and lesbian clients.