The primary aim of this study was to investigate the content and extent of psychotherapy patients’ disclosures to their spouses or significant others about their experiences in therapy, the perceived impact of disclosure about therapy on the spousal relationship, and its perceived impact on the therapeutic relationship and on treatment satisfaction. Adult psychotherapy patients (N = 84) in individual treatment, who identified themselves as either married or in a significant romantic relationship completed the Disclosure About Therapy Inventory – Revised (DATI-R; Khurgin-Bott & Farber, 2014), a revision of the Disclosure About Therapy Inventory (see Khurgin-Bott & Farber, 2011). This 52-question survey was designed to explore the extent and content of patients’ disclosures to their therapists, and the extent and content of their disclosures about therapy to their spouses or significant others (“partners”). The DATI-R also includes three outcome measures: the Revised Dyadic Adjustment Scale (RDAS; Busby, Christensen, Crand, & Larson, 1995) measures the quality of participants’ relationships with their partners, the Working Alliance Inventory – Short Revised (WAI-SR; Hatcher & Gillaspy, 2006) assesses the quality of their relationships (alliances) with their therapists, and the outcome items of the Disclosure to Therapist Inventory-III (DTI-III) assess their satisfaction with their treatment. Findings indicate that overall, patients were very disclosing to their therapists and moderately disclosing to their partners about their therapy. No demographic variables (including gender, marital status, duration of psychotherapy, and duration of marriage/relationship) were significantly associated with or predictive of the extent of patients’ self-disclosure about therapy. A significant positive association was found between the extent of disclosure to partners about therapy and the extent of self-disclosure to therapists. Greater extent of disclosure about therapy to partners was also associated with better quality of therapeutic alliances and with higher relationship satisfaction (with partners). Additionally, the quality of therapeutic alliances was strongly predictive of better treatment outcomes. These findings suggest that married (or coupled) patients in individual psychotherapy may benefit from the open discussion of their experiences in therapy with their spouses or significant others, or at least that such openness is characteristic of patients in satisfactory relationships (both therapeutic and marital). These findings are discussed in the context of the methodological limitations of the current study and the particular characteristics of the sample, and clinical implications and directions for future research are explored.

Group psychotherapy with borderline patients is an activity that is fraught with ominous apprehension and it is perhaps for this reason that little research has been done in the field. The aim of the present studies was to map out the area and to test some basic hypotheses about patient and therapist behaviour during the therapy process. Two therapy groups of carefully diagnosed clinical borderline patients were studied by means of video-technique during a therapy process of 20 months. Special technical arrangements and ethical agreements were elaborated for the research. Outcome data was collected concerning the patients’ self-image, symptom-level and personality structure. A follow-up was done 2-3 years after therapy on functional level, capacity for work, medication and need of further treatment. As expected a high drop-out rate occurred. Within a year 40% of the patients had left, and within 20 months 60%. Drop-out was not found possible to predict before the period of therapy commenced but early drop-outs were generally younger and in a more acute state of distress than late drop-outs. In order to study the therapy process two major perspectives were elaborated and operationalized: 1) classification of focus and depth of therapists’ interventions and 2) relational capacity of the patient (Borderline Relatedness). In contrast to remainers, late drop-outs were found most sensitive to disturbances in the frame of therapy (group instability) and were considered prone to interact malignantly with the therapists, eventually leading to drop-out. As to outcome and follow-up, late drop-outs were characterized by the poorest outcome all over, while early drop-outs and remainers were generally more stabilized although the early drop-outs seemed more dependent on medication for their functioning. By means of a principal components analysis the large amount of outcome data was condensed to two important factors: 1) symptom and functional level and 2) direction of anger. Thus, it was found that an important feature of a positive outcome was the ability to function at work and in social life and to direct anger outwards, not just towards oneself, thus protecting and idealizing important others, as was often the case with these patients before treatment. Taken together, the results point to the need for more precise and sensitive diagnostic methods and outcome criteria both to predict and to evaluate therapeutic outcome. To minimize drop-out and negative therapeutic reaction the research speaks in favor of further studying the therapist-patient interaction during the group therapy process and to evaluate the relative importance of therapist interventions and non-specific curative factors. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1989, härtill 4 uppsatser.</p> / digitalisering@umu.se

To date, there has not been research that disaggregates the experiences of Asian American and international Asian college students seeking psychotherapy in college campus settings. We examined archival data collected over the course of a 17-year period that focused on experiences of Asian American, international Asian, and European American students at a large university in the intermountain west, US. More specifically, we used archival data to identify differences between the aforementioned groups of students in regard to psychotherapy utilization, presenting concerns, distress levels endorsed at intake, and distress levels endorsed at termination. Results were calculated based on findings from the Family Concerns Survey (FCS), Presenting Problem Checklist (PPC), and Outcome Questionnaire 45 (OQ-45). Results indicate no significant differences between these three groups in terms of the maximum number of psychotherapy sessions attended. Cox Regression analyses showed no significant differences between these groups of students in regard to their likelihood for treatment discontinuance. Odds Ratio analyses yielded little statistical difference between groups in terms of likelihood of attending therapy. We found significant differences between these groups of students on a number of items related to their presenting concerns. Additionally, we found a significant difference between students in these three groups in regard to the severity of their presenting distress (as measured by the Outcome Questionaire-45), with international Asian students presenting with the most distress followed by Asian American students and finally European American students. We also found a significant difference between these groups of students in treatment improvement as measured by change scores on the Outcome Questionaire-45 with European American students experiencing the greatest change, followed by Asian American students, followed by international Asian students. Given the nature of these results, practitioners are admonished to attend to initial distress levels upon intake as well as Asian American and international Asian students' experience of racism and discrimination. Practitioners are also encouraged to align treatment recommendations with the specific world view of the client they are meeting with.

The current study examined the psychotherapy experiences of Pacific Islander and Asian American students at a large intermountain university on the continental United States. We used archival data collected over a 17-year span to investigate the psychotherapy utilization, presenting concerns, reported distress levels and psychotherapy outcomes of Pacific Islander students compared to Asian American students. In an effort to address the current and problematic practice of combining Asian Americans and Pacific Islanders into a homogeneous category, subgroup outcomes of Pacific Islander students were compared to Asian American students to highlight any significant differences and similarities. Results indicated significant differences between Pacific Islander and Asian American students in terms of amount of psychotherapy sessions attended and length of treatment in days. Asian American students were more likely to remain in therapy during the first 100 days and eight sessions. We found significant differences between both groups on several items assessed in the Presenting Problem Checklist and the Family Concerns Survey. Pacific Islander students reported significantly more traumatic experiences occurring in their family. We also found significant differences in the presenting concerns of both populations. Additionally, on the OQ-45, Pacific Islander students answered questions regarding risk factors significantly different from Asian American students. Clinicians are encouraged to understand the values and nuances of collectivist groups including Pacific Island and Asian cultures. It is recommended that clinicians and counseling centers reach out to Pacific Islander students on their campuses to inform them about mental health services. Counseling centers are encouraged to gather information on the reasons for therapy termination.

Individualism, the assumption that persons are self-contained and primarily act for the sake of the self, is prevalent in American culture and has arguably perpetuated numerous psychological and societal ills. Relationality, the assumption that persons are always and inextricably constituted by relationships, has been posited as a philosophical and practical alternative to individualist culture. Several scholars, both inside and outside of psychology, have developed relational concepts and practices, including some who have elucidated a relational approach to psychotherapy (e.g., Slife and Wiggins, 2009). This study examines the implications and effects of this therapeutic approach, particularly exploring relationality's therapeutic success in countering the implications of individualism. Greenbrier Academy, an adolescent female boarding school located in West Virginia, has adopted relationality as its guiding therapeutic ethic. This study utilized hermeneutically modified grounded-theory methods to inquire into the lived experience of students at Greenbrier Academy. Eight students were interviewed and the researcher recorded observations of daily programing over a six-day period. Results indicated that Greenbrier's students' experienced marked changes in the quality and meaning of their interpersonal relationships. They increasingly cared for and served their relationships, engaged in more intimate relationships with others, approached (rather than retreated from) others' differences, viewed others more holistically, and accepted personal responsibility in relation to their context.

Unexpected dramatic changes in psychotherapy have been observed historically and tied to high recovery rates. Many different methodologies that identify these changes are assumed to be capturing similar or identical phenomena. This study compared three methods – Sudden Gains (SG), Percentage Increase – 50% (PI-50%), and Rapid Response (RR) - in a large database looking for similarities and differences. Results suggest that there are significant differences between SG, RR, and PI-50 as methods for operationally defining unexpected dramatic treatment response, and caution should be used when referring to SG, PI-50, and RR as the same phenomenon or interchangeable terms for unexpected dramatic treatment response. In particular, overlap in clients who experienced both a SG and RR was low. Experiencing any of the three phenomenon was associated with higher recovery rates, while differences abound in both which clients experience each of the phenomena and demographic characteristics of those clients. PI-50 identified inconsequential amounts of clients suggesting under its current methodological construction it would have limited useability. These results tying SG, RR, and PI-50 to significant rates of recovery and positive treatment change suggest possible future use as a predictive feedback tool for clients and clinicians alike to be better able to examine the effectiveness of treatment components during treatment.

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No description available.

The Outcome Questionnaire (OQ-45; Lambert et al., 1996) has been widely employed as a psychotherapy outcome monitoring measure following research findings that support various aspects of its validity and sensitivity to change. Despite its broad usage in both clinical and research settings, some of its psychometric properties are not definite. The three subscales of the OQ-45 are designed to measure three distinct, but related, aspects of psychological functioning. However, neither the one- nor three-factor models have been supported by previous research. Likewise, the results of the current study supported neither of those factor structures. It was suspected that heterogeneity in data might have led to the lack of the confirmatory factor analysis model fit. Therefore, factor mixture modeling (FMM), a combination of confirmatory factor analysis and latent class analysis, was employed to investigate potential heterogeneity of the data. Among the series of factor mixture models with varying numbers of classes that were fitted, the two-class, unconditional FMM based on the revised three-factor solution was decided to best describe the data under analysis. Although three covariates of clinical status, sex, and race were selected as known sources of heterogeneity and incorporated into the FMMs (i.e., conditional model), the findings were contradictory to expectations. The implications of these findings in counseling were discussed in terms of aggregating OQ-45 scores and its score interpretation. Furthermore, this study demonstrates the process involved and dilemmas encountered in choosing the best fitting FMM. There is currently no criterion for assessing individual model fit. Instead, models’ fit are compared using various information criteria (IC). And, as was found in the current study, these ICs are frequently contradictory. Thus, the process of identifying the best fitting model cannot rest solely on fit indices but must also depend on interpretation of models and consideration of the ultimate use of the results. In the current study, consideration of transition matrices and the pattern of latent means across classes contributed as much to model selection as fit index interpretation. / text

The current trend in psychiatric health care is towards comprehensive primary healthcare for all South Africans. This has been has been achieved by the restructuring of the National Health System (NHS) into national, provincial, district, and community levels, which provide outpatient and inpatient care at primary, secondary, and tertiary care levels. Assessment and treatment in the form of physical and psychosocial interventions form an integral part of psychiatric care. The value of personality assessment and, in particular, the potential for matching patient personality types with effective treatment options, may play a role in facilitating effective health care in the future. An overview of the literature indicates that little research has been done regarding the area of personality traits of psychiatric patients in South Africa. This study aims to explore and describe the personality traits or profile of individuals attending a private psychiatric day care facility in The Nelson Mandela Metropole (i.e., Parkwood Day Clinic). The sample consisted of 196 participants (104 male and 92 female) who attended a group programme from April 2000 to April 2001. As part of the programme, patients were required to com plete a series of pencil-and-paper measures. The questionnaires selected for this study included a biographical questionnaire, which was used to describe the biographical variables of the sample with regard to gender, age and marital status, and The Revised NEO Personality Inventory (NEO PI-R) (Costa & McCrae, 1992a), which was used as a measure of personality. The NEO PI-R is considered a concise measure of the five major domains of personality and some of the more important traits that define each domain. Together, the five domains Neuroticism (N), Extraversion (E), Openness (O), Agreeableness (A) and Conscientiousness (C), and the six facets within each domain, allow for a comprehensive assessment of adult personality. xiv An exploratory, descriptive method was used in the study, and the data was analysed using descriptive and inferential statistics, including correlations, cluster analysis, and multivariate analysis of variance. Key findings include the following: Results from the NEO PI-R domains showed a personality profile of very high scores for N, and average scores for E, O, A, and C. Within the sample, cluster analysis revealed five distinct personality profile clusters. For the biographical variable gender, significant differences were found between males and females on N, with the majority of males scoring in the category of Very High and High, and the majority of females scoring in the Average category. For the variable age, the results indicated significant differences on A, with participants in the young adulthood group scoring significantly lower on A than participants in the middle adulthood group. For marital status, on the domain of O, significant differences were found between the divorced or widowed and the married, with the married scoring in the Low category and the divorced or widowed in the Average category. On the domain of C, significant differences were noted between the singles group and the currently or previously married groups, with the single group tending to score lower on C than both other groups. These findings reveal a need for further research into personality traits and psychiatric samples, as consideration of personality traits based on the profile established, may be useful in matching patients’ characteristics with optimal treatment options.