The aim of this study is to investigate Iranian psychotherapists’ behaviors and beliefs toward sexual orientation and gender identity. The sample consisted of 358 Iranian psychotherapists, of whom 29.3% were male and 67% were female. Results from the chi-square analyses showed that more male participants reported accepting homosexual clients and treating them as having a pathological disorder than their female counterparts; and licensed respondents reported engaging more in accepting only male or female clients, accepting more homosexual and transgender clients for (...) treatment, and treating them as having a pathological disorder when compared with their unlicensed counterparts. Furthermore supervised respondents reported accepting more homosexual clients than their unsupervised counterparts. However results from the multivariate analysis of variance has indicated that the female participants reported “accepting homosexuals or transgender clients for treatment” more often than the male participants; unsupervised participants reported “accepting homosexual or transgender clients for treatment” and “treating homosexuality per se as a pathological disorder” more often than their supervised counterparts. (shrink)

This study examined how psychotherapists address hypothetical nonsexual multiple relationships dilemmas with Asian American clients and identified predictors of conservative decisions and the use of culture-based rationales. This survey of 787 Asian American and non-Asian American psychotherapists revealed that clinicians rely on mostly their personal policies and seldom focus on the clients' cultural backgrounds. Psychotherapists who consider their clients' Asian culture have more cultural knowledge and awareness, have been mental health providers longer, and are Asian American and female. Clinicians who (...) avoid multiple relationships tend to cite formal policies as justification and are less likely to consider clients' cultural worldviews, the therapeutic relationship, or their own values. The results are discussed in terms of specific revisions needed in the American Psychological Association Ethics Code, the benefits of more frequent consultation with colleagues and supervisors about ethical dilemmas, and recommendations for psychotherapists. (shrink)

While psychotherapists are trained to improve their clients’ quality of life, little work has examined the quality of life experienced by psychotherapist trainees themselves. Yet their life satisfactions and stresses would plausibly affect both their ability to learn new skills and conduct psychotherapy. Therefore, in the Society for Psychotherapy Research Interest Section on Psychotherapist Development and Training study, we investigated the patterns of self-reported life quality and their correlates in a multinational sample of 1,214 psychotherapist trainees. A (...) comprehensive questionnaire was used at the outset of trainings to assess trainees’ professional background, current life situation, personal characteristics, family background, and social and national origin. The findings indicated 54.3% of trainees’ lives could be characterized as fortunate or happy, whereas 14.3% could be characterized as clearly distressed or troubled. The strongest correlates of high life stress, a contributor to poor life quality, were economic insecurity, self-protectiveness, and attachment-related anxiety in relationships, and economic or psychological hardship in childhood. In turn, greater wellbeing was most strongly associated with a warm and open interpersonal style, being married, having sufficient economic means, and material and emotional security in childhood. While the results indicate the majority of therapists experience a relatively good quality of life, the findings also suggest potential targets for increasing trainees’ life quality when it may be deficient, such as those on a societal level, training program level, and individual level, in order to promote effective learning and therapy practice. (shrink)

Dealing with errors in psychotherapy is challenging, both ethically and practically. There is almost no empirical research on this topic. We aimed (1) to explore psychotherapists’ self-reported ways of dealing with an error made by themselves or by colleagues, and (2) to reconstruct their reasoning according to the two principle-based ethical approaches that are dominant in the ethics discourse of psychotherapy, Beauchamp & Childress (B&C) and Lindsay et al. (L).

In 1988, Colorado instituted a new regulatory system that was opposed by psychologists and social workers. We surveyed 306 psychotherapists about their attitudes regarding this system, which included profession-specific licensing boards and an omnibus board to handle grievances. Social workers and psychologists, members of more established professions, opposed creating an omnibus licensing board and favored the return of profession-specific grievance functions. Members of the newer professions and unlicensed psychotherapists were not as opposed to omnibus boards. All groups agreed in their (...) positive ratings of the performance of the Colorado grievance structure. These results are discussed in terms of "capture" theory, which postulates that professions capture governmental regulation and use it for their own interests. (shrink)

This paper presents a dialogue between a psychotherapist whom we will call Lilly, and Ross Channing Reed, Ph.D., a philosopher and philosophical counselor. Lilly begins by asking Ross a series of questions regarding philosophical counseling and his approach to working with her. Ross discusses his philosophy and approach to philosophical counseling, what it is like to provide counseling for a therapist, and the educational nature of philosophical counseling. Topics addressed include the nature of unarticulated trauma, the repetition compulsion, moral (...) evil, the narrative construction of a human life, the potentially debilitating effects of moralizing about feelings, the importance of humor, spirituality and philosophy, embodiment, the arts, and Alice Miller’s concept of the “Enlightened Witness.” Next, Ross asks Lilly a series of questions relating to her personal and professional journey prior to and during philosophical counseling. Lilly reveals that she spent significant time in therapy with a psychologist prior to philosophical counseling. She discusses why she sought counseling from a philosopher, how philosophical counseling has been beneficial in her personal and professional lives, and how philosophical counseling has been different from other forms of counseling. (shrink)

Basics of awareness : knowing yourself -- Basics of awareness : privilege and social responsibility -- The process of acculturation : developing your professional ethical identity -- The ethical culture of psychotherapy -- "I can't believe it's not therapy" : boundaries of the psychotherapy relationship -- Confidentiality : a critical element of trust in the relationship -- Informed consent : the three-legged stool -- Making the most of supervision -- Ending psychotherapy : the good, the bad, and the ethical -- (...) Putting it all together : toward ethical excellence. (shrink)

Within a perspective that views groups as communities of practice and sites of construction of knowledge, learning, and identity, this article aims to explore the contribution that participation in different groups over the course of one’s life provides to the development of the professional practices of psychotherapist trainees enrolled in the C.O.I.R.A.G. school, an Italian graduate program in group psychotherapy. Through qualitative analyses of 10 semi-structured interviews, our study empirically shows that by participating in groups, the trainees not only (...) learn the practices of that group but also develop a sort of meta-learning which takes place across groups. The results highlight that: Transversality, duration, and informality are found to be the group properties with the highest formative value; and Learning practices across different groups have common characteristics: are organized around complex topics of group life, began in early group experiences, are in continuous evolution, are associated with a critical event, and a negative affect. At the same time, it seems that these critical events are exactly what triggered and sustained the learning practices. Data from the interviews also showed how professional identities are constructed as the outcome of learning in different communities of practice. The study outlines how the experience made in different groups is elaborated in and through meaningful self-narratives, highlighting them as a fundamentally collective and culturally shaped sense-making process. Overall, these results contribute to a better understanding of learning processes as situated and jointly constructed through multiple group participations over time. Furthermore, they contribute to highlighting the role of self-narratives as a primary way through which trainees shape their identity as self-reflexive professionals who are competent in reading group dynamics. Directions for future research and suggestions for psychotherapist training paths are outlined in the conclusions. (shrink)

Since the 1980s, psychoanalysis and psychotherapy have attracted great interest in Chinese society, and in parallel, the psychotherapist as a character has emerged in Chinese literature. Through four novels by three Chinese authors, namely, Xu Xiaobin 徐小斌, Ke Yunlu 柯云路, and Bi Shumin 毕淑敏, this article studies the evolution of the image of the psychotherapist in contemporary Chinese literature, which reflects the reception of psychoanalysis as well as the development of psychotherapy in China. In Xu Xiaobin’s novel, two (...) psychology students attempt to cure a psychotic patient through “transference therapy” based on a complete misunderstanding of the notion; Ke Yunlu features a “life counselor” who, like typical good counselors in Chinese classical novels, simply gives advice without caring about the patients’ needs and desires; and the two novels by Bi Shumin show a significant change in the writer’s understanding of the profession and therapeutic methods, as well as the current, unregulated situation of psychotherapy in China. (shrink)

With a reassuring and clear writing style, Willer offers practical suggestions and clinical examples to address the professional development and emotional concerns of the beginning psychotherapist. She guides readers through structuring the first session, making clinical observations, and establishing a therapeutic alliance. Through the use of culturally diverse clinical vignettes, Willer discusses the foundations of ethical practice, including informed consent, confidentiality, documentation, and setting boundaries. The reader is guided on how and when to refer clients for medication and other (...) health care. Crisis management principles are detailed, including suicide and violence risk assessment, child abuse, elder abuse, intimate partner violence, and rape. Willer also provides professional advice on contemporary concerns such as social networking, online searches of clients, the psychotherapist's internet presence, and other important emerging challenges. Comprehensive, practical, and thoroughly updated, The Beginning Psychotherapist's Companion, Second Edition is the ideal resource for students and early career psychotherapists. (shrink)

Studies report that psychotherapists overestimate their own performance. This study aimed to examine if the self-assessment bias in psychotherapists differs between therapeutic orientations and/or between social comparison groups. Psychotherapists gave subjective estimations of their professional performance compared to two social comparison groups. They further rated the proportion of their patients recovering, improving, not changing, or deteriorating. In total, N = 229 Austrian psychotherapists participated in the online survey. Psychotherapists rated their own performance on average at M = 79.11 relative to (...) “all psychotherapists” vs. at M = 77.76 relative to “psychotherapists with the same therapeutic approach”. This was not significantly different between therapeutic orientations. A significant interaction between social comparison group and therapeutic orientation revealed a drop of self-assessement bias in social comparison group “same approach” vs. “all psychotherapists” in psychodynamic and humanistic therapists. Psychotherapists overestimated the proportion of patients recovering, improving and underestimated the proportion of patients not changing and deteriorating, with no differences between orientations. The self-assessment bias did not differ between therapeutic orientations, but the social comparison group appears to be an important variable. A major drawback is that results have not been connected to patient-reported outcome or objectively rated performance parameters. (shrink)

Beneficence and integrity comprise two of the five principles of the American Psychological Association (American Psychological Association [APA], 2017) code of ethics. The connection between ethic...

This article examines the issue of nonsexual relationships between psychologists and their former therapy clients. What little research is available concerning nonsexual relationships with former clients suggests that psychologists have clear reservations about some of these relationships, especially personal ones and intentional social interactions. Relationships immediately following termination are seen as particularly suspect. Drawing on the literature dealing with multiple relationships in general, and sexual relationships with former clients in particular, a number of arguments are made outlining why psychologists should (...) avoid significant nonsexual relationships with former clients for at least some period of time following termination. (shrink)

Life Witness is a blueprint for the formative evolution of a psychotherapist: from beginner/technician who practices a single school of therapy to a seasoned clinician with a transtheoretical paradigm. Ultimately such a clinician, by transcending the field of psychotherapy itself, becomes a master psychotherapist and addresses the larger dilemmas of human existence -- the context within which all patients' psychological conflicts are experienced. -- from book jacket.

Do psychotherapists' unethical practices influence how they are perceived? The 202 Israeli lay and professional psychology participants rated systematically varied descriptions of effective therapists and potential clients under conditions of no difficulties, practice without a license, and a previous sexual boundary violation on indexes of evaluation and willingness to refer. Participants completed a measure of important variables in therapist selection. Effective standard therapists were rated most favorably, unlicensed therapists were rated favorably, and therapists who violated sexual boundaries in the past (...) were rated least favorably. When results were analyzed by respondent characteristics, laypersons rated unlicensed professionals and sexual boundary violators more positively than did clinical psychologists. Men rated the violators more favorably than did women. Factor analysis of therapist selection measures identified professional and personal factors, but only the former were associated with ratings of "problem" therapists. The results underscore the gap between ethical standards and applied decisions made by professionals and laypersons. Further investigation is needed to ensure quality care in both professional and consumer approaches to psychotherapy. (shrink)

The article is a description of Rimas Kociunas’ seminar “The picture of human life and the therapeutic process: the introduction of an existential psychotherapist”, held in Moscow from February 13 to 16, 2020. The seminar was devoted to the study of the basic philosophical principles of existential psychotherapy on which work with a client is based. A specificity of existential therapy is the lack of specific technical methods and methods of working with a client, therefore the content of therapeutic (...) work is determined by a particular vision of a person and his problems. From the point of view of existential therapists, the personality is in constant interaction with the world, the result of which is continuous formation; therefore, instead of studying the qualities and structures of the personality, one should study its life world and ways of building relationships with reality. (shrink)

Background: Mental health professionals working in correctional contexts engage a double role to care and control. This dual loyalty conflict has repeatedly been criticized to impede the development of a high-quality alliance. As therapeutic alliance is a robust predictor of outcome measures of psychotherapy, it is essential to investigate the effects of this ethical dilemma. Methods: This qualitative interview study investigates patients’ perceptions of their therapists’ dual role conflict in court-mandated treatment settings. We interviewed 41 older incarcerated persons using a (...) semi-structured interview guide, the interviews were subsequently analyzed following thematic analysis. Results: We first present the patients’ perceptions of their treating psychotherapist’s dual loyalty conflict, which was linked to their overall treatment experience. In a second step, we outline the study participants’ reasons for this judgment, which were most commonly linked to feelings of trust or betrayal. More specifically, they named certain therapist characteristics and activities that enabled them to develop a trustful therapeutic alliance, which we grouped into four topics: respecting the patient’s pace and perceived coercion; patient health needs to be first priority; clarity in roles and responsibilities; and the art of communication – between transparency and unchecked information sharing. Discussion: Developing a high quality alliance in mandatory offender treatment is central due to its relationship with recovery and desistance. Our findings show that some therapists’ characteristics and activities attenuate the negative impact of their double role on the development and maintenance of the alliance. To increase the effectiveness of court-mandated treatments, we need to support clinicians in dealing with their dual role to allow the formation of a high quality therapeutic alliance. Our qualitative interview study contributed to this much-needed empirical research on therapist’ characteristics promoting a trustful relationship in correctional settings. (shrink)

The present study is a cross-sectional survey that investigates ethical practices among Chinese psychotherapists from the perspective of a large representative sample of Chinese clients (N?=?1,100). In reports from clients, we found that psychotherapists did poorly in providing informed consent and had other ethical difficulties in the therapeutic setting and with dual relationships. We conclude that Chinese culture, especially Confucianism, had significant impact on the attitudes toward the psychotherapists' ethical practices, which complicated ethical dilemmas. It is important for cross-cultural psychotherapists (...) to become sensitive to the influences of traditional Chinese culture when counseling Chinese clients. (shrink)

The current investigation examines the incidence of clients telling their psychotherapists of committing violent crimes for which they have not been prosecuted. Thirteen percent of the psychologists surveyed indicated that on at least one occasion a client self-disclosed to them during a psychotherapy session that he/she had murdered someone, not including the killing of another person in the line of duty in the military or as a public peace officer. One third of the psychologists had clients self-disclose an unprosecuted incident (...) of a sexual assault, and more than two thirds had clients self-disclose an unprosecuted incident of a physical assault during a psychotherapy session. Data are reported on psychotherapists' views of the impact of such disclosures on the psychotherapy relationship, adequacy of being informed regarding legal obligations after hearing such reports of violence, and adequacy of graduate preparation to deal with these clinical situations. (shrink)

The purpose of this study was to explore the impact of Buddhist meditation practice on the attitude, work and lived experience of therapists and their self-reported experiences of work with clients. The research describes particular dynamics and effects of meditation on six psychotherapists who practiced Buddhist meditation for over five years in the Theravadin , Zen and Vajrayana traditions. Interviews and follow-up interviews were conducted by the researcher combining both structured and open-ended formats. A phenomenological analysis of the interviews with (...) the privileged subjects is the method utilized to make sense of the data. Summaries of each subject's interviews were prepared. A co-reader expert in phenomenological analysis participated with the researcher in a dialogal process to challenge and clarify the themes that emerged from the interviews. ;The findings revealed five primary themes that emerged in the interviews: conviction/grounding, mindfulness of the present, impermanence, suffering, and skepticism of melodramas. These are discussed from the viewpoint of each of the subjects as they addressed them in the interviews. There were three essential meaning structures that emerged from the phenomenological analysis. These are described as a trinity with each bearing a crucial relationship to the other in how meditation impacts the work of these therapists. The essential meaning structures consist of conviction/grounding, skepticism of melodramas, and mindfulness in the present. These themes are also discussed from the viewpoint of three-fold logic of ground, path, and fruition. ;A critique of the phenomenological research is presented. Acknowledgment is made regarding the limitations and benefits of conducting this method of research. Implications of the findings for the training of therapists is discussed. Further related research is suggested. (shrink)

This paper articulates a radical feminist analysis of psychotherapist-patient sexual exploitation, a problem that has affected an estimated one million North American women. I argue that such exploitation is rooted in misogynous attitudes that pervade the major institutions in contemporary culture, including the mental health professions. I examine ways that mental health professionals use sexist constructs and language to blame victims for their abuse. Through textual analysis of a series of letters and articles by prominent psychiatrists, I show that (...) the male writers attempted to silence victims and their female advocates by subjugating the women's voices to their rhetorical control and by indirectly drawing on the power of deeply-held cultural stereotypes of women. This analysis of therapist-patient sexual exploitation and the blaming of its victims points to the broader problem of oppressive androcentric bias in psychiatry's ideology, epistemology, and discourse. The article closes with a suggestion for correcting psychiatry's harmful biases and with recommended strategies for preventing psychotherapist-patient sexual exploitation. (shrink)

This study explored relations between willingness to disclose in 5 psychotherapy scenarios and 2 independent variables. Scenarios involved suicidal, gravely disabled, physically abusive, and sexually abusive patients, and a police officer patient who shot a suspect. For each of the 5 scenarios, participants in the privilege condition had significantly higher willingness-to-disclose scores than participants in the no-privilege condition. There were no significant differences between willingness-to-disclose scores of participants with and without therapy experience; neither was there a significant interaction between privilege (...) condition and therapy experience. Privilege condition was more predictive of willingness to disclose than personal characteristics or therapy experience. Results provide empirical support for the U.S. Supreme Court's recognition of the psychotherapist-patient privilege in Jaffee v. Redmond. (shrink)

Although the psychotherapist's personal psychotherapy has received considerable research attention in recent years, little systematic investigation of the ethical issues involved has been published. This article provides a rigorous interrogation of mandatory personal psychotherapy as a training requirement for mental health professionals, a topic that remains ethically contentious. The article begins with a discussion of why MPP is an explicitly ethical issue, before debating the ethics of MPP under six questions, each worded to capture a salient ethical issue relevant (...) to the appropriateness of making personal treatment a mandatory training requirement. Using principle, virtue, and care ethics perspectives, the arguments for and against MPP are critically investigated. The article concludes with an ethical position statement. (shrink)

BackgroundThe legal and ethical guidelines of psychological professional associations stipulate that informed consent by patients is an essential prerequisite for psychotherapy. Despite this awareness of the importance of informed consent, there is little empirical evidence on what psychotherapists’ attitudes towards informed consent are and how informed consent is implemented in psychotherapeutic practice.Methods155 psychotherapists in Switzerland completed an online survey assessing their attitudes regarding informed consent. ResultsAmong the surveyed psychotherapists, there was a high consensus on important information that should be communicated (...) to patients in the context of informed consent. Almost all psychotherapists rated confidentiality and its exemptions (95%) and self-determined decision-making (97%) as important. The importance to disclose information regarding fees and the empirical effectiveness of the provided treatment, were both seen as important by more than 80% of participants. The disclosure of personal information about the therapist was rated as important by 60%. Other aspects, which are not direct components of informed consent but rather overarching goals, were also evaluated rather homogeneously: self-determined decision making of the patient was rated as important by almost all of the surveyed psychotherapists (97%). The following components were also judged as important by a majority of the participants: promotion of hope (80%) and discussion of treatment goals (93%). Most psychotherapists described the implementation of informed consent as an ongoing process, rather than a one-time event during the first session of therapy. Therapists’ age, postgraduate training, treated patient group, and setting influenced attitudes towards informed consent.ConclusionsThe present study shows that informed consent is perceived by psychotherapists as both a challenge and a resource. The implementation of informed consent in psychotherapy requires further research from a clinical and ethical perspective. (shrink)

This paper presents the results of an empirical study among two groups of psychotherapists in the Netherlands. One group works in a mental health institution based on religious principles , and the other group in a general mental health institution . The investigation starts with an overview of the religious background and religious practices of the therapists. Some equations with the average Dutch citizen are made. The next part of the study deals with the perception by psychotherapists of religious issues (...) connected with psycho-social problems. How often in their opinion is there a relation and what kind of relation is at issue? The third part of the study considers the way in which psychotherapists treat these religious issues. Do they attend to them and what kind of interventions are used? Special attention is given to the question of whether there are contacts with the clergy. We conclude that religion should be given a more pronounced place in general mental health care and that Riagg psychotherapists, in particular, should become better equipped to deal with religious issues. (shrink)

Mental health chatbots (MHCBs) designed to support individuals in coping with mental health issues are rapidly advancing. Currently, these MHCBs are predominantly used in commercial rather than clinical contexts, but this might change soon. The question is whether this use is ethically desirable. This paper addresses a critical yet understudied concern: assuming that MHCBs cannot have genuine emotions, how this assumption may affect psychotherapy, and consequently the quality of treatment outcomes. We argue that if MHCBs lack emotions, they cannot have (...) genuine (affective) empathy or utilise countertransference. Consequently, this gives reason to worry that MHCBs are (a) more liable to harm and (b) less likely to benefit patients than human therapists. We discuss some responses to this worry and conclude that further empirical research is necessary to determine whether these worries are valid. We conclude that, even if these worries are valid, it does not mean that we should never use MHCBs. By discussing the broader ethical debate on the clinical use of chatbots, we point towards how further research can help us establish ethical boundaries for how we should use mental health chatbots. (shrink)

Summary This paper presents and contextualizes the construct of Aesthetic Relational Knowing (ARK), as the intuitive experience of the therapist that emerges from the phenomenological field created in a meeting between therapist and client. The concept of isomorphism is considered as an epistemological turning point and a possible bridge connecting Gestalt therapy, Gestalt theory and Neurosciences. An example of the clinical consequences of this change of perspective is given. Moreover, a validation pilot study has shown that ARK is described by (...) three factors: empathy, resonance and bodily awareness. The ARK can be defined as a three-dimensional construct that supports the positive use of the therapist’s perception in terms of aesthetic knowing of the phenomenological field of the therapeutic situation. The construct of Aesthetic Relational Knowing can be considered a phenomenological, aesthetic and field-oriented contribution to psychotherapy training, supervision and research. (shrink)

This volume provides a comprehensive and accessible introduction to the emerging concept of the evolution of consciousness. It presents an overarching model that moves us to a new level of meaning and understanding of our place in the world.

This volume is a newly revised and updated edition of _Evolution and Consciousness_ (Brill, 2019) and provides a comprehensive and accessible introduction to the emerging concept of the evolution of consciousness. It presents an overarching model that moves us to a new level of meaning and understanding of our place in the world.

Let me begin by summarizing my understanding of some of Hersch’s main points. He proposes 1) that “the use of existential themes and concepts” and “an existential ontology provides a more suitable philosophical grounding for psychotherapeutic theories and practices”; and 2) that “an existential version of the mental status examination… can provide us with a more in-depth understanding of…an individual’s experiential world”. According to Hersch, an existential perspective directs our attention to the existential guilt and anxiety “present inherently in the (...) human situation”. The former, “existential guilt,” “is a kind of.. (shrink)

Written by a former corporate manager pursuing counseling as a 2nd career, this article offers pointed views on managed mental health care. Values of practitioners that are a mismatch for managed care are noted, and more specific disadvantages and advantages are examined. Loss of client confidentiality is addressed and procedures and technologies for its reclamation are noted. Negative effects on therapy are acknowledged and potential for better accountability and research are pointed out. Economic disadvantages of a small provider's practice as (...) well as opportunities for creating new value and additional income are reviewed. The relatively sudden emergence of managed care is credited with a natural time lag preceding regulatory responses. Acknowledging that most new practitioners have little choice about the clients they serve, the article concludes that it would be shortsighted to rule managed care out of one's practice. (shrink)

In this article, I will try to illustrate some ways in which an existential ontology, based on a phenomenological elaboration of the basic structures or themes of human existence, may prove useful to us in psychotherapeutic theory and practice. A number of philosophers as well as a number of theorists and practitioners of psychotherapy have weighed in on the topic of whether ontology and psychology can or should influence each other and how. In many cases, these discussions have hinged upon (...) the ontological/ontic distinction, particularly as articulated in Martin Heidegger’s Being and Time. In brief, I characterize that distinction by saying that the ontological discussion falls clearly within the.. (shrink)