The adult client's conception of confidentiality in the therapeutic relationship and the valuing of this confidentiality was examined and defined in this paper. The importance of confidentiality and its effect on the therapeutic process was explored. Many professionals in the field of mental health believe that confidentiality is a critical factor in the successful outcome of therapy (Hayt, 1977; Lowenthal, 1968; Reynolds, 1976; Tancredi & Slady, 1975). It is viewed that confidentiality is expected by clients when entering into a therapeutic relationship, and is essential in the therapeutic process. The variables that may affect the client's conception of, attitudes toward, and valuing of confidentiality were examined and reported (i.e., age, sex, annual income, treatment modality inpatient vs. outpatient). One of the main purposes of this paper was to develop and accurately assess how important confidentiality is to the client undergoing mental health treatment. It was proposed that data for 76 persons undergoing either inpatient or outpatient mental health treatment would be obtained at a local mental health center with both inpatient and outpatient mental health services available. An additional 50 subjects (employees of the hospital) were utilized as a control group. All 126 of the subjects completed a 20-item survey which assessed general attitudes toward casehandling issues, privileged communication, and past experience of perceived violations of confidentiality in a therapeutic relationship. Questions 19 and 20 were deleted for the control group. The subjects ranged in age from eighteen to seventy. It was expected that the subjects of the treatment groups would value confidentiality highly and support the hypothesis that confidentiality is a crucial issue in psychotherapy. The results of the research support the hypothesis that clients undergoing mental health treatment do, in fact, highly value confidentiality. Also, differences do exist between sample groups, the inpatient group valuing confidentiality more highly than either the outpatient sample or the control sample, respectively. Casehandling issues (i.e., secretarial typing of reports, taking of sessions) is of no concern to clients. Most clients also believer their communications in a therapy session are protected legally. Finally, most clients have not perceived a violation of confidentiality in a past or current therapeutic relationship.

This project investigated the spiritual well-being (SWB) of psychotherapists in training and their physiological reactions to religious questions posed by a mock client. Electrodermal activity served as an index of physiological arousal interpreted as anxiety. Thirteen psychotherapists in training at the University of North Texas were recruited. They participated in a simulated intake session with a mock client who asked the psychotherapist neutral questions, personal-other questions (POQs), and personal-religious questions (PRQs). It was discovered that the level of SWB did not affect subjects' anxiety responses to PRQs. There also was no difference in subjects' anxiety responses for POQs between high and low SWB therapists. However, psychotherapists did experience some anxiety associated with questions related to their counseling experience and expertise.

Child-centered play therapists are taught unique relationship building approaches and therapeutic methods to utilize when working with children. The purpose of this study was to determine if adult clients counseled by child-centered play therapists would demonstrate greater positive therapeutic outcomes than adult clients who were counseled by non-educated child-centered play therapists. This study also attempted to determine if the play therapists' clients would show greater, significant improvement in any particular areas of client distress (i.e., depression/anxiety, relationship issues), more so than the clients of the non-play therapists. Archival data from an assessment, The Adult Self-Report Inventory (ASR), was gathered to measure reported pre and post-test client symptomology. This study utilized a 2X2 repeated measure ANOVA design to analyze the impact of counselors who were educated in child-centered play therapy who saw adult clients, versus their non-play therapy counterparts who saw adult clients. Before treatment pre-test and after treatment post-test administration was collected for use in the analysis. The population consisted of 60 adult clients seeking counseling services at a major university in the southwest. All clients were seen by Master's practicum students for ten sessions. The clients were divided into two groups - 30 were seen by play therapists, 30 were seen by non-play therapists. Five scales on the ASR were measured using a 2x2 split-plot design and Eta squared. There were three independent variables: group, measurement occasion, and the interaction between group and measurement. The results of this study did not reveal any statistical significance. However, clinical significance was demonstrated as the play therapists' clients did report greater reductions in symptomology on all five scales, some more than others.

Given the importance of client characteristics and preferences, and therapist expertise to evidence-based practice in psychology, the current study sought to contribute to the literature concerning the role of values in psychotherapy. Personal values of clients and trainee therapists in 29 dyads were examined for relationships between client and therapist values and associations with working alliance and outcomes. Although previous literature in this area has suggested that successful therapy is characterized by an increase in similarity of client and therapist values, the current study did not replicate this finding. However, client perceptions of therapist values were found to be important to working alliance and outcome. Findings are discussed in terms of suggestions for future research as well as implications for clinical practice, including the importance of discussing expectations and preferences with clients.

The purpose of this study is to contribute to the current process research by investigating a psychotherapist's experience during psychotherapy. Massage therapy and relaxation therapy were used to manipulate psychotherapist's bodily focus, physiology, and affective state. Topics discussed include: the bodily focus of the therapist, neurobiological models of experience, mind-body boundary issues, and a present-time focus. Doctoral level Counseling and Clinical graduate students were used as participants.

The purpose of this study was to explore heterosexual bias in the diagnosis and treatment of gay males. Two hundred-fifty (134 males and 116 females) mental health professionals from the Division of Psychotherapy (29) of the American Psychological Association participated in the study. Participants were randomly assigned to one of two case history conditions, which presented a 35-year-old male seeking therapy. Both conditions were equivalent with regards to the presenting problem (i.e., diagnostic symptoms) with the exception of his significant other (i.e., gay vs. non-gay condition). Potential bias was measured through a diagnostic rating Likert scale and a treatment plan questionnaire. Other independent variables that could potentially have an effect on diagnostic ratings were explored, such as gender, year of graduation, and theoretical orientation of the respondents. Results of the statistical analyses failed to confirm evidence of heterosexual bias. Implications for further research and training are discussed.

The relationship was investigated between named staff members and four measures of reported alocohol consumption by alcoholics followed up one year after hospitalizstion in state hospitals. The 559 representative subjects were located, interviewed, and matched with 65 staff members named as "most helpful" to determine social, economic, and drinking aspects. Named personnel were administered the A-B Scale by Campbell, Stevens, Uhlenhuth, and Johansson (1968). Subjects naming A-staff members reported significantly lower levels of alcohol consumption on two of four measures as compared to subjects naming A/B- or B-staff members. Additional followup variables tended to support this conclusion.

The present study examined the impact of gender and sex-role orientation on therapy effectiveness. Previous research suggested that same-sex pairings and androgynous therapists would be most desirable. Interviewers (therapists) were 25 male and 15 female third-year doctoral psychology students, each interviewing a male and a female undergraduate student (client). Results did not support the hypothesis that gender and sex role were powerful predictors of therapy effectiveness. However, this study did find that therapist self-rated interpersonal competency and accurate self-perception predicted therapy effectiveness for female clients. Therapists' consistency in using various parameters (techniques) of therapy was related to client perceived effectiveness. Opposite-sex pairings were less likely to result in momentary feelings of discomfort during initial interviews.

This study investigates affect coding within the therapeutic relationship, by exploring the client's and therapist's perception of the relationship and the facial and vocal affect expressed by both parties. A sample of 14 therapy sessions each having 1800 data points was collected. The Working Alliance Inventory Short Form (WAI-S) and Real Relationship Inventory (RRI) were completed after each recorded session. The participants were therapists and clients at a university counseling center in South Florida. Data were analyzed using one-tailed t tests, descriptive statistics, scores from RRI and the WAI-S and percentages of negative, neutral and positive affect. Statistically significant relationships were found between seconds of therapist negative affect (t(13)= -2.065, p. <.05) and seconds of therapist neutral affect (t(13)= -1.959, p. <.05) for clients who dropped out of therapy. The seconds of negative affect coded for clients (t(13) = -1.396, p. >.05) was approaching statistical significance for clients who drop out of therapy. This study provides theoretical and empirical support for linking the presence of facial affect in the first session and its effects on the therapeutic relationship and thus client retention or drop out. The clinical implications of these findings are also discussed. / by Ashley J. Luedke. / Thesis (Ph.D.)--Florida Atlantic University, 2013. / Includes bibliography. / Mode of access: World Wide Web. / System requirements: Adobe Reader.

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.