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Background The present study examines the psychometric properties of the German adaptation of the Client Attachment to Therapist Scale (CATS). The validity of the scale as originally proposed has recently been brought into question, as patients were identified as “pseudosecure”. Methods We examined the measure’s factorial structure, as well as reliability and validity towards related measures using a clinical sample of N = 354 participants. Results We found the original model, consisting of 36 items to be lacking in terms of model fit and construct validity. A shortened 12-item version exhibited markedly improved model fit and reliability. Correlations to related constructs demonstrated that none of the scale’s validity was lost by shortening it. Furthermore, we showed scalar invariance across groups of age and sex. Conclusions The shortened CATS-S can be recommended for future use in clinical research in German-speaking populations as a valid, reliable, and economical alternative to the longer version.

This qualitative study aimed to explore how to handle aggression in therapy from a Gestalt perspective. In order to reach the aim of this study a conceptual framework was done exploring terms central to this project including aggression and Gestalt Play therapy. Unstructured, telephonic interviews were then conducted with seven Gestalt Play therapists working with children in the Western Cape exploring ways to handle and treat aggression in therapy. The data collected during these interviews were then analyzed and several themes were identified and explored by conducting a literature control. Guidelines were then formulated and written on how to handle aggression in therapy from a Gestalt perspective as part of the concluding chapter of this research report. / Social Work / M. Diac (Play Therapy)

Text in Afrikaans / Die komplementariteit tussen afstand en intimiteit in die terapeutiese verhouding word ge"illustreer en bespreek aan die hand van 'n enkeie gevallestudie. Die klem is op rekursiewe en selfverwysende prosesse wat tussen die terapeut en kiient plaasvind, sodat die vvyse waarop intiemer en meer afstandelike interaksies ge-kokreer is, uitgelig word. Die terapeutiese proses word binne die raamwerk van die ekosistemiese en sosiale konstruksionistiese epistomologie bespreek. Navorsing word uitgevoer volgens die naturalistiese navorsingsparadigma en raakpunte tussen die navorsingsparadigma en epistomologie wat bespreek is, word aan die hand van die gevaliestudie ge"illustreer. In die studie word daar ook verwys na verwante kwessies, soos aanraking en grense in die terapeutiese verhouding, terapie as 'n a-sosiale konteks, terapie as 'n paradoksale situasie en die neutraliteit van die terapeut, wat aansluit by die tema van hierdie studie. Hierdie temas word geintegreer tydens die bespreking van die gevallestudie. / An individual case study is used in this study, to discuss the complementarity between distance and intimacy in the therapeutic relationship. The focus is on recursive and selfreflective processes between the therapist and the client in order to explain the way in which intimate and distant interactions were coconstructed. The therapeutic process was discussed in the context of ecosystemic and social constructionist epistemologies. Research was done according to the principles of the naturalistic research paradigm and overlaps between this research paradigm and epistemologies that were discussed are brought forward through the discussion of the case study. There are also references in this study to related issues, such as touching and boundaries in the therapeutic relationship, therapy as an a-social and paradoxical context, and the neutrality of the therapist, which connect with the theme of this study. These themes are integrated in the discussion of the case study. / Psychology / M.A. (Kliniese Sielkunde)

This paper discusses how I have made an original contribution to the field of family therapy and systemic practice in relation to three themes: the therapeutic relationship; working with emotions in therapy, and self-reflexivity in practice. I track how these three themes have developed in the course of my research and clinical practice between 1983 and 2008 and then go on to show how I have developed these themes into an original 'practical theory' that has broader application to the field of family therapy and systemic consultation. I put forward eight publications, focusing on my two books, 'Death Talk: Conversations with Children and Families' (Fredman, 1997) and 'Transforming Emotion: Conversations in Counselling and Psychotherapy' (Fredman, 2004). I show how my original contributions to the field of family therapy theory and systemic practice take forward the following issues debated in the field in the past ten years: systemic therapy's theorising of the therapeutic relationship; -the use of cybernetics, psychoanalysis and social constructionism in systemic family therapy; -the relationship between modern and postmodern approaches in the field of family therapy; -the relationship between theory and practice.

The increasing diversity of the United States creates a pressing public health need to investigate methods to increase the engagement, retention, and efficacy of mental health services for racial/ethnic minority (REM) youth. Evidence from the adult psychotherapy treatment literature suggests that enhancing therapist cultural competence leads to increases in client satisfaction, alliance, and retention (Constantine, 2002; Sodowsky, Kuo-Jackson, Richardson, & Corey, 1998; Worthington, Soth-McNett, & Moreno, 2007). However, this relationship has not been adequately explored in youth mental health services, due in part, to a lack of valid and reliable measurement. This research project included measure development and initial validation of the Youth Therapist Observational Cultural Competence Scale (YTOCCS) with the aim of creating an observer-rated measure of youth therapist cultural competence. The measure was developed from a review of the theoretical and empirical literature and integrated the surveyed opinions of practicing child therapists, caregivers of REM children involved in the mental health system, and experts in therapist cultural competence. The study used an extreme group design based on child-therapist alliance selecting 32 recordings of 8 unique child-therapist dyads. Three coders were trained using a standardized manual and independently double coded early treatment sessions from an effectiveness trial for individual child cognitive-behavioral therapy conducted in community clinics. The measure demonstrated good reliability as measured by intraclass correlation coefficient, adequate internal consistency, and evidence supported initial validity through demonstrated significant between-group differences. Future studies are warranted to refine the measure and to explore the factor structure of the measure.

Diploma thesis deals with the possibilities of using logotherapeutic principles for clients in residential care. It shows the importance of interpersonal relationships among the long-term sick and dying people. It is focused on social work in the context of helping professions. In detail it deals with the disabled people. To provide the most effective care the knowledge of the specific disability is necessary. Different types of complex approaches to clients in residential facilities are mentioned and humanistic and existential theories of social work are summarized. The main part of the thesis concerns logotherapy and search for the meaning of life using logotherapeutic principles. Theoretical way-outs are evidenced by personal experience, mainly from the hospital environment, from the work with long- term sick and dying clients.

Made available in DSpace on 2016-07-27T14:21:40Z (GMT). No. of bitstreams: 1 Ana Carolina Aquino de Sousa.pdf: 859405 bytes, checksum: 012e102cd1c0ae09167374dd9968980d (MD5) Previous issue date: 2004-12-03 / This research is an effort to explore, from a functional analytic perspective, the feelings that dealing with borderline clients causes in therapists. First, the therapeutic relationship is described as an instrument that can promote changes in the client s repertoires. This approach considers that if an individual behaves in relation to a therapist in the same way as he behaves in his daily life in relation to other people, these settings are functionally identical. So, changes in one context, will affect the others. Besides, the client s behaviors cause feelings in the therapist (a phenomenon known in psychotherapy literature as counter-transference) that can be used as cues about how other people feel in the client s daily life. So, the therapeutic relationship would be a context that makes in-vivo learning possible for the client, since the behavior can be immediately reinforced or weakened after its occurrence. Four behavioral therapists, who worked with borderline clients, took part in this research. The sessions were conducted weekly and lasted one hour each. Reports by the therapists concerning their feelings were recorded during semistructured interviews and during monthly supervisions with each therapist separately. All recordings were transcribed and explored according the methods of grounded theory. The results indicate that the therapists noted the occurrence of clinically relevant behaviors and countertransference in the therapeutic relationship. During supervision it was tried to lead the participants to use their own feelings (about the client) as cues to promote changes in clients behaviors. They reported that their clients punished many of their new behaviors they were coerced to continue reacting in ways that were complementary to the client s behaviors. The therapists what went back to behave in a way that was safe for them reinforced the problem behaviors of their clients. This counter-therapeutic behavior seems related to experiential avoidance. The results suggest that particular attention to interpersonal interactions during the session is important. It could avoid that the therapeutic relationship maintains the client s problems and can make it possible to take better advantage of the therapist s private responses. / O presente trabalho é um esforço em explorar sentimentos que o atendimento ao cliente borderline provoca em terapeutas, a partir de uma visão analítico-funcional. Primeiro, a relação terapêutica é descrita como um instrumento de mudança que pode promover mudanças no repertório do cliente. Esta abordagem parte do pressuposto de que se o indivíduo se comporta em relação ao terapeuta da mesma maneira que o faz no seu dia a dia com outras pessoas, esses ambientes são funcionalmente idênticos, e que, portanto, se um deles for mudado, esta alteração afetará os demais. Além disso, os sentimentos que os comportamentos do cliente provocam no terapeuta (fenômeno conhecido na literatura psicoterápica como contra-transferência) podem servir como dicas sobre o que outras pessoas do seu cotidiano sentem. Desta forma, a relação terapêutica seria um contexto que possibilita o aprendizado ao vivo para o indivíduo, já que o comportamento pode ser reforçado ou enfraquecido imediatamente após a sua ocorrência. Participaram deste trabalho, quatro terapeutas comportamentais que atendiam clientes borderlines. Elas realizavam os atendimentos semanalmente com sessões de uma hora de duração. Relatos de sentimentos dos terapeutas foram gravados durante entrevistas semiestruturadas e durante supervisões mensais com cada terapeuta separadamente. Todas as gravações foram transcritas e exploradas de acordo com os métodos da teoria fundamentada nos dados. Os resultados apontaram que os terapeutas percebem a ocorrência de comportamentos clinicamente relevantes e de contra-transferência na relação terapêutica. Tentou-se, nas supervisões, levar as participantes a utilizar dos seus próprios sentimentos em relação ao cliente, como dicas para atuar de modo a promover mudanças no repertório do cliente. Elas relataram que muitos dos novos comportamentos adotados por elas, foram punidos pelos seus clientes sendo isto coerção para continuar reagir de forma complementar aos seus comportamentos. As terapeutas, que voltavam a se comportar de modo mais seguro para si reforçaram os comportamentos problemáticos dos clientes. Tal comportamento contra-terapêutico parece relacionado com a esquiva experiencial. Os resultados sugerem que atenção particular para os padrões interpessoais durante a sessão poderia evitar que a relação terapêutica chegasse a manter os problemas do cliente e que um melhor proveito das respostas encobertas do terapeuta para este fim é possível.

Submitted by admin tede (tede@pucgoias.edu.br) on 2017-04-24T19:44:51Z No. of bitstreams: 1 ARTUR VANDRÉ PITANGA.pdf: 1155422 bytes, checksum: d38ede4d87eb51abb30a4007b224dafd (MD5) / Made available in DSpace on 2017-04-24T19:44:51Z (GMT). No. of bitstreams: 1 ARTUR VANDRÉ PITANGA.pdf: 1155422 bytes, checksum: d38ede4d87eb51abb30a4007b224dafd (MD5) Previous issue date: 2016-08-25 / Behavioral and cognitive behavioral psychotherapy have, in recent decades, evolved in the way they speak, understand and manage the therapist – client relationship. Three waves of behavioral psychotherapy mark this development, adding to clinical psychologys, interest in subjective and experiential aspects of the therapist – client relationship. The psychotherapeutic relationship can provide significant and change experiences both the patient and the therapist. Various feelings can arise during a session, including sexual feelings or romantic attraction to the patient by his psychotherapist. Psychotherapies describe how therapists should understand, use and manage feelings in the relationship with the patient. Contemporary behavioral psychotherapies invite psychotherapists to use their own person and their feelings as a therapeutic tool. This makes it is necessary to know how this requirement works for the professional person in daily office reality. This thesis seeks to clarify specifically what involves the sexual feelings of the patient in the therapeutic relationship and how therapists handle these feelings of the patient. The main objective is to clarify the impact and implications of sexual feelings of the patient, the therapeutic relationship in behavioral analytic and cognitive behavioral psychotherapy. The research is qualitative in nature, exploratory and interpretive, according to a contextual approach and inductive method, framed on grounded theory analyses. 28 therapists (27 female and 1 male) with at least two years of professional experience, were intervened about situations experienced in the clinical environment related to attempted sexual involvement and romantic approach by patients. The semistructured interviews were transcribed and subjected to analytical coding with the intention of allowing categories that describe the dynamics of sexual feelings of the patient in view of the therapist who is the object thereof. Patients try to break boundaries by commenting on the therapist physical characteristics, idealize and praise the therapist, report sexual fantasies in relation to the therapist, ask the therapist personal questions, ask the therapist out and try to obtain prolonged physical contact and intensity breaching the conventional patterns. The impact on the feelings of therapists are embarrassment, discomfort, guilt, discomfort and helplessness, bewilderment and shock, shame and feeling disrespected and void. Behavioral therapists try to manage alliance ruptures by making the relationships blocking patient problem behavior, seeking external support, or taking advantage of the sentiments expressed by the patient for the therapeutic process. As a result the some patients quit therapy, and others remain in treatment and experience benefits in term behavioral change. / As psicoterapias comportamentais e cognitivo comportamentais apresentam desenvolvimento nas ultimas décadas na maneira de intervir, compreender e manejar a relação entre psicoterapeuta e paciente. Três gerações de psicoterapia comportamental marcam esse desenvolvimento, conferindo ao trabalho de psicologia clínica interesse sobre aspectos subjetivos e vivenciais da relação entre psicoterapeuta e paciente. A relação psicoterapêutica pode proporcionar transformações e vivências significativas tanto para o paciente, quando para o terapeuta. Vários sentimentos podem surgir durante uma sessão, entre eles os sentimentos sexuais ou aproximação romântica do paciente por seu psicoterapeuta. As psicoterapias descrevem como os terapeutas devem entende, usar e manejar sentimentos na relação com o paciente. As psicoterapias comportamentais contemporâneas convidam o psicoterapeuta a usar sua própria pessoa e seus sentimentos como ferramenta terapêutica, faz-se necessário saber como essa exigência funciona para a pessoa do profissional na realidade do consultório. A presente tese procura esclarecer, especificamente, o que envolvem os sentimentos sexuais do paciente na relação psicoterapêutica e como os terapeutas manejam esses sentimentos do paciente. O objetivo principal é esclarecer sobre o impacto e as implicações dos sentimentos sexuais do paciente, no relacionamento terapêutico na psicoterapia analítico comportamental e cognitivo comportamental. A pesquisa tem cunho qualitativo, exploratória e interpretativa, de acordo com uma abordagem contextualista e método indutivo, tendo como base a teoria fundamentada nos dados (grounded theory). Foram entrevistados 28 terapeutas, (27 do sexo feminino e 1 do sexo masculino) com no mínimo dois anos de atuação profissional, convidados a relatar situações vivenciadas em ambiente clínico relacionadas à tentativa de pacientes de envolvimento sexual e aproximação romântica. As entrevistas semiestruturadas realizadas foram transcritas e submetidas a codificação analítica com a intenção de permitir a emergência de categorias que descrevem as dinâmicas dos sentimentos sexuais do paciente na perspectiva do terapeuta que é objeto destes. Pacientes tentam romper limites na relação ao comentar características físicas que a terapeuta possui, idealizar e elogiar a terapeuta de forma sedutora, relatar fantasias sexuais em relação à terapeuta, fazer perguntas pessoais à terapeuta, convidar a terapeuta para sair e tentar obter o contato físico prolongado e com intensidade fora do padrão convencional. O impacto sobre os sentimentos dos terapeutas: constrangimento, desconforto, culpa, incomodo e impotência, espanto e susto, vergonha e sentir-se desrespeitado e invalidado. Terapeutas comportamentais tentam manejar as rupturas do quadro clínico tentando tornar a relação mais profissional, bloqueando comportamento do paciente, buscam apoio externo, ou aproveitam os sentimentos expressos pelo paciente para o processo terapêutico. Como consequência do manejo dos terapeutas alguns pacientes desistem, sendo que outros permanecem na terapia e experimentam benefícios em termo de mudança comportamental.

A Psicoterapia Analítica Funcional (FAP) baseia-se no behaviorismo radical e propõe como mecanismo de mudança a modelagem de comportamentos clinicamente relevantes (CCR) na interação terapêutica. Diversas pesquisas tem comprovado a eficácia desse mecanismo de mudança, porém um estudo detalhado das variáveis envolvidas nessa modelagem se faz necessário. Nesse sentido, o presente estudo teve como objetivos verificar os efeitos sobre os CCRs produzidos por dois tipos de intervenções: FAP não sinalizada (FAPNS) e FAP sinalizada (FAPS), e comparar essas intervenções com intervenções analítico comportamentais com foco em análise de contingências externas à terapia (ACE). As intervenções FAPNS consistiram na modelagem de CCRs na interação terapêutica. Já as intervenções FAPS, além da modelagem continham as seguintes variáveis: 1. sinalização e descrição pelo terapeuta da ocorrência de CCRs na interação com o cliente; 2. descrição do terapeuta ao cliente do impacto que os CCRs produzem nele (com relação a sentimentos, pensamentos, etc.); e 3. paralelos realizados pelo terapeuta dos comportamentos do cliente em sessão e fora dela.. Foi utilizado um delineamento intra-sujeito de reversão, de tratamentos múltiplos (A1 B1 A2 C1 A3 B2 A4 C2 A5) para estudar os efeitos dessas intervenções em dois clientes com problemas em relacionamentos interpessoais. A ordem de apresentação das fases foi alternada para cada participante. As sessões foram filmadas e analisadas utilizando o instrumento Functional Analytic Psychotherapy Rating Scale FAPRS. Foram analisadas 27 sessões de cada participante. Os resultados corroboram que a modelagem dos CCRs é o mecanismo de mudança na FAP, visto que os CCRs2 aumentaram de frequência e os CCRs1 diminuíram nas fases em que a FAPS ou FAPNS foram introduzidas. Com o delineamento utilizado conseguimos observar as reversões nas frequências de CRBs nas mudanças entre as fases FAP e ACE. Não foram encontradas diferenças evidentes entre as duas formas de intervenção, FAPS e FAPNS, indicando que a modelagem ocorre quando o terapeuta apresenta a consequência adequada aos CCRs, independente da descrição dos comportamentos / Functional Analytic Psychotherapy (FAP) is based on radical behaviorism and proposes that the shaping of clinically relevant behavior (CRB) is the instrument of behavioral change. Many researches demonstrated this mechanism, but a detailed analysis of the variables is necessary. The objective of this research was to study the effects of two different FAP interventions on CRBs: Non-signalized FAP Interventions (FAPNS) and signalized FAP interventions (FAPS), and compare those interventions with sessions of behavioral psychotherapy, with focus on analysis of contingencies external to therapy (ACE). FAPNS interventions consist of shaping the client´s behavior throughout the course of therapeutic interaction. FAPS interventions, in addition to shaping CRBs during therapeutic interaction, contain the following variables: 1) signaling and description by the therapist of the occurrence of CRBs during the interaction with the client, 2) description of the CRBs impact on the therapist (e.g., the therapists feelings, thoughts, etc., produced by the clients CRBs), and 3) description of parallels between CRBs and the clients behavior outside therapeutic setting. We used a within-subject withdrawal design with multiple treatments (A1 - B1 - A2 - C1 - A3 - B2 - A4 - C2 - A5) to study those variables in two clients with interpersonal relationship problems. We controlled the order of presentation of each phase for the participants. The sessions were filmed and then coded using the Functional Analytic Psychotherapy Rating Scale-FAPRS. 27 sessions of each participant were analyzed. The results show that the shaping process of CRBs is the main mechanism of change in FAP since the CRBs 2 increased while the CRBs 1 decreased during FAPS and FAPNS phases. We observed the reversion of CRBs frequencies between FAP and non FAP phases (ACE), but we did not find differences between FAPS and FAPNS interventions. This indicates that the shaping process of CRBs occur when the therapist presents the precise consequences for each CRBs, even if the consequences do not include the description of the behaviors that take place between therapist and client