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The main focus of this research was to explore how counselling psychologists experience what that they cannot understand in the therapeutic process. The study focuses on how counselling psychologists make sense of and manage these experiences, as well as the role such experiences play in therapy. Although the existence of such occurrences are acknowledged in the foundations of many therapeutic approaches (Bion, 1970; Bugental, 1990; Freud 1915; Jung, 1923; Maslow, 1971; Ogden, 1999; Perls, 1973; Rogers, 1961; Stern, 2004) , there seems to be a lack of research in relation to how these phenomena are experienced and what role they play in the therapeutic process. Eight counselling psychologists with ten years of experience in clinical practice were recruited and interviewed using semi-structured interviews. Different aspects of these experiences were explored through applying the qualitative method known as Interpretative Phenomenological Analysis (Smith, 2004). The findings suggest that the way counselling psychologists experience phenomena that cannot be understood strongly relates to anxiety, fear and uncertainty, drawing attention to deep feelings of vulnerability and insecurity. The results demonstrate the ambivalent meanings of such experiences in the therapeutic process, and their significance in the process of therapy. The thesis also comprises the way in which counselling psychologists spoke about these phenomena and how these occurrences were managed by counselling psychologists. Some conclusions were made about what kind of knowledge counselling psychologists relied on while making sense of such phenomena. The recommendations made as a result of the research show validity as they closely relate to the way counselling psychologists explore their own identity as professionals. Also, the research highlighted the essentiality of exploring the role of theoretical knowledge and reflexivity for counselling psychologists. The research also explores unanticipated findings such as the existence of those experiences that need to remain undefinable and the ability of counselling psychologists to let go of the need to make sense of phenomena. The study also addresses the limitations and implications of the research, and suggestions for further research are indicated.

The purpose of this study was to investigate whether different time arrangements for individual psychotherapy vary in effectiveness for the vi therapeutic process. The following time arrangements were compared against each other: Treatment I, 1/ 2 hour sessions twice per week; Treatment II, 1 hour sessions once per week; and Treatment III, 2 hour sessions every other week. Twenty-one subjects and seven therapists were selected from six mental health facilities in Utah and Idaho for this project. All therapists participating had at least 2 years experience as psychotherapists. All subjects were randomly assigned to one of the three treatments. Each therapist received one subject for each of the three treatments under study, which spread therapist differences equally across treatments. It was found that time arrangements, by themselves, have no effect upon outcome as measured by the D, Pt, and Sc scales of the MMPI, and a Therapeutic Progress Questionnaire which attempted to tap the subjects' evaluation of their therapeutic experience. When all subjects (Ss) were compared between pre- and posttesting, it was found that, overall, patients improved significantly (beyond the . 01 level) as measured by the D and Sc scales of the MMPI. The Pt scale of the MMPI showed improvement beyond the . 05 level of significance--thus, indicating that patients improved regardless of whether they were seen for 30 minute sessions, 1 hour sessions, or 2 hour sessions, when all subjects completed a total of 8 therapy hours before posttesting.

Objective: Therapeutic processes that occur within session have been identified as a factor that may influence youth anxiety outcomes. The present study examined the relationships between positive and negative youth involvement, therapist therapeutic and nontherapeutic behaviors, and anxiety outcomes. Method: Sixty youth (aged 7-17) received cognitive-behavioral therapy for an anxiety disorder. Weekly session videos were rated by observers. Measures of anxiety severity were completed weekly and at posttreatment. Regression analyses examined the association between therapeutic processes and post-treatment outcomes. Univariate and bivariate latent difference score (LDS) models evaluated whether changes in one factor were prospectively associated with later changes in the same factor and in other factors. Results: Positive youth involvement significantly predicted reduced anxiety severity, greater improvement, and remission of principal anxiety disorder at posttreatment. Youth negative involvement during psychoeducation sessions predicted a reduced likelihood of remission. Therapist therapeutic behaviors during psychoeducation sessions predicted lower anxiety severity, greater improvement, and treatment response. Nontherapeutic behaviors in psychoeducation sessions were associated with increased anxiety severity, less improvement, and a reduced likelihood of treatment response and remission of principal anxiety disorder. When entered simultaneously, only nontherapeutic behaviors were significantly associated with increased anxiety severity. LDS models resulted in poor model fit, thus, the temporal sequence among involvement, therapist behaviors, and anxiety severity was not established. Conclusions: Youth involvement and therapist behaviors are associated with beneficial outcomes. Therapist nontherapeutic behaviors are strongly associated with poorer outcomes. Findings are discussed in relation to previous findings and future directions are proposed. / Psychology

Recent research on working with families in which one child is suffering from a developmental disability has indicated a need for more focused clinical attention on the well sibling or neurotypical sibling experience. Research has also suggested that a systemic approach to the therapeutic process would be the most beneficial to all members of the family system, including the well sibling. Although the literature supports the use of systemic interventions in supporting the well sibling, there is a gap between what the research is suggesting and the clinical application. In an effort to fill this gap, this study sought to explore how Marriage and Family therapists are working systemically with families in which one child has a disability to incorporate the needs of the well sibling. After conducting four qualitative interviews and analyzing the data, three central themes emerged: 1) stabilization; 2) involving the well sibling; and 3) methods of support. Clinical implications as well as suggestions for future research are also addressed. / Master of Science

This study seeks to qualitatively explore and understand counselling psychologists experience of subjective and objective countertransference within individual therapy and how this affects the counselling process. Historically the available literature suggests that the development of countertransference has been dominated through theoretical papers rather than empirical research. The complex nature of countertransference amongst practitioners can often cause controversy and debate when it is further broken down into subjective and objective factors. Not only does this impact the therapist, the client and the working alliance, but also the larger systems operating around these variables. This study provides a rich and detailed examination of subjective and objective countertransference through the methodology of Interpretative Phenomenological Analysis (IPA). Six counselling psychologists participated in a face-to-face semi-structured interview revealing countertransference in three parts; subjective, objective and contributory factors giving rise to seven superordinate themes. ‘Subjective’ Super-ordinate revealed ‘Professional, Personal and Reactors’. ‘Objective’ Super-ordinate found ‘Clients life outside the analysis’ and ‘Contributing Factors to Countertransference’ Super-ordinate encapsulated ‘Service restrictions, Therapeutic Relationship and Training’. These findings support several conceptual and theoretical published papers, however this empirical investigation adds to the literature through further informing clinical practice. It does so by separating parts of countertransference, digging deeper into those parts in an isolated way showing the affective processes, techniques, the interplay of evoked feelings to better manage countertransference in the moment of experiencing it and overall how this impacts the therapeutic relationship. Future research could consider exploring how counselling psychologists in the UK focus their attention on distinctive parts of subjective and objective countertransference (subjective countertransference thoughts, subjective countertransference feelings and subjective countertransference behaviours, as well as objective countertransference thoughts, feelings and behaviours separately), further research would also benefit from qualitative investigations of subjective and objective reactions when working with certain populations, for example, diagnosis/symptom-specific individuals, certain demographics and/or investigating couples or family systemic groups and whether this has any impact on the working alliance, therapeutic technique, intervention and outcome. Potential clinical implementation include counselling psychologists becoming better positioned to recognise when subjective and objective countertransference is occurring, what to do with it through the application of techniques and how to maintain a ‘good enough’ working alliance.

The authors integrate explorations by Blatt and colleagues of contributions of patient personality, therapeutic relationship, and change in mental representation to sustained therapeutic change. A pretreatment personality characteristic, self-critical perfectionism, a negative self-schema, significantly interfered with therapeutic progress in manual-directed, brief outpatient treatment for depression. The therapeutic relationship, however, facilitated changes in this negative self-representation, leading to sustained therapeutic change. The authors also explored change in the content and structural organization of representations of self and significant others in long-term, intensive inpatient treatment. A detailed clinical example elaborates the processes through which the therapeutic relationship facilitates changes in the thematic content and cognitive structural organization of patients' interpersonal schemas that appear to be the basis for sustained therapeutic gain.

Background: Exposure tasks—where an individual confronts a feared stimulus or situation—are known to be a key element of the treatment for youth anxiety. However, optimal therapist behaviors during these exposure tasks and the specifics of how therapist should conduct exposure tasks have not been determined. The current study examined the relationship between therapist behaviors that (a) increased, (b) decreased or (c) maintained the youth’s anxiety during exposures and treatment outcomes. Methods: Participants were youth (N = 107) ages 7 to 17 who received cognitive behavioral therapy for anxiety. Youth and their primary caregiver(s) completed a diagnostic interview and self- and parent-report measures pre- and post-treatment. Exposure session videos were rated by observers trained to reliability on a coding system evaluating therapist behaviors. Hierarchical regression analyses examined the role of therapist behaviors in predicting treatment outcomes. Logistic regression assessed the ability of therapist behaviors to predict treatment responder status (i.e., being a treatment responder versus a non-responder). Exploratory analyses examined the relationship between the individual therapist behaviors (within the three overall categories of behaviors) and treatment outcomes. Results: Youth showed significant improvement over the course of treatment. The three categories of therapist behaviors used during exposure tasks (increase, decrease and maintain the youth’s anxiety) were not associated with treatment outcomes. Discussion: Findings indicate that so long as exposure tasks are conducted, the therapist behaviors during the exposures may not be as important for predicting outcomes. Clinical implications, study limitations, and future directions are discussed. / Psychology

Submitted by Fabricia Fialho Reginato (fabriciar) on 2015-07-23T00:20:08Z No. of bitstreams: 1 MarindiaBrandtner.pdf: 535266 bytes, checksum: 44b2e59858f1e72c770653a7c499c7af (MD5) / Made available in DSpace on 2015-07-23T00:20:08Z (GMT). No. of bitstreams: 1 MarindiaBrandtner.pdf: 535266 bytes, checksum: 44b2e59858f1e72c770653a7c499c7af (MD5) Previous issue date: 2012 / Nenhuma / Esta Dissertação de Mestrado aborda o processo de mudança terapêutica na Terapia Cognitivo-Comportamental (TCC), com ênfase na patologia do comprar compulsivo. A dissertação compõe-se de uma revisão sistemática sobre psicoterapia para casos de compras compulsivas e de um estudo empírico do processo de mudança em um caso de TCC. A revisão sistemática da literatura partiu do tema das compras compulsivas e suas opções psicoterapêuticas. Para tanto, foi efetuada uma busca nas bases de dados MEDLINE (NLM), Social Sciences Citation Index (Web of Sciences), Science Citation Index Expanded (Web of Science) e American Psychological Association (APA) com as palavras-chave psychotherapy (psicoterapia) and (e) compulsive buying (compras compulsivas), compreendendo o período de 2002 a 2012. Foram excluídos artigos de teóricos, de revisão e que avaliavam exclusivamente tratamento psicofarmacológico. Do total de 96 encontrados, apenas seis preencheram os critérios de inclusão. Os estudos encontrados, apesar de poucos, apontaram que existem estudos sendo desenvolvidos com propósito de testar e validar intervenções efetivas para o tratamento das compras compulsivas. Apesar dos indícios de efetividade de abordagens psicoterápicas no tratamento do comprar compulsivo, a escassez de estudos, a ausência de estudos comparativos entre diferentes psicoterapias, entre outros aspectos, indicam a necessidade de implementar pesquisas sobre a efetividade do tratamento psicológico face a face com este tipo de psicopatologia. O estudo empírico teve como objetivo avaliar resultados do tratamento psicoterápico de uma compradora compulsiva e descrever o processo terapêutico. A pesquisa foi realizada em uma clínica privada do interior do Estado do Rio Grande do Sul. As participantes foram uma terapeuta, psicóloga e especialista em Terapia Cognitivo-Comportamental, com mais de dez anos de experiência na área e uma paciente, adulta, casada, com sintomas de comprar compulsivo, aliados a depressão. Foram realizadas 12 (doze) sessões de psicoterapia, utilizando o enfoque da TCC. Todo o tratamento foi gravado em áudio e posteriormente transcrito e avaliado por uma dupla de juízes independentes, através do método Psychotherapy Process Q-Set (PQS) para a obtenção de descrições quantitativas de elementos que caracterizaram o processo terapêutico, considerando fatores da paciente, da terapeuta e da interação entre ambas. A avaliação dos resultados foi obtida através de medidas antes, durante e após o tratamento, de sintomas de comprar compulsivo (YBOCS-SV), ansiedade (BAI), depressão (BDI-II) e de ajustamento social (EAS). Este estudo apontou que a TCC foi efetiva no tratamento de comprar compulsivo, promovendo a redução de comportamentos disfuncionais típicos desta patologia, a reestruturação de cognições disfuncionais da paciente e a melhora dos sintomas de depressão e de ajustamento social. Os achados não permitem generalizar quais fatores foram mais importantes para estes positivos resultados, porém, a aliança terapêutica, as tarefas comportamentais, a motivação da paciente e a atitude de apoio da terapeuta, foram fatores essenciais para este processo. / This Master´s Dissertation discusses the process of therapeutic change in cognitivebehavioral therapy (CBT), with emphasis on pathology of compulsive buying. The dissertation consists of a systematic review on psychotherapy for cases of compulsive buying and an empirical study of the change process in a case of CBT. A systematic review of the literature came from the theme of her compulsive buying and psychotherapeutic options. The search found 96 articles, only six of which met the inclusion criteria. The articles found, though few, have pointed out that there are studies being developed for the purpose of testing and validating effective interventions for compulsive buying treatment. Despite the evidence of effectiveness of psychotherapeutic approaches in the treatment of compulsive buying, the scarcity of studies, the lack of comparative studies between different psychotherapies, among other things, indicate the need to implement research on the effectiveness of psychological face to face treatment with this type of psychopathology. The empirical study aimed to evaluate psychotherapy results of a compulsive buyer and to describe the therapeutic process. The research was conducted in a private clinic in the state of Rio Grande do Sul. Participants were a therapist, psychologist and expert in Cognitive Behavioral Therapy, with over ten years of experience in the field and a patient, adult, married, with symptoms of compulsive buying, coupled with depression. Twelve (12) sessions of psychotherapy were performed, using the approach of CBT. All treatment was recorded on audio, transcribed, and evaluated by a pair of independent judges with the method Psychotherapy Process Q-Set (PQS) for obtaining quantitative descriptions of elements that characterize the therapeutic process, considering patient’s, therapist’s and interaction’ factors. The evaluation of results were obtained through measurements of compulsive buying symptoms (YBOCS-SV), anxiety (BAI), depression (BDI-II) and social adjustment (EAS), performed before, during and after treatment. This study showed that CBT was effective to treat compulsive buying, promoting reductions of dysfunctional behaviors that are typical of this condition, restructuring patient´s dysfunctional cognitions and improving depressive symptoms and social adjustment. The findings do not allow generalizing what factors were most important to these positive results. However, therapeutic alliance, behavioral tasks, patient´s motivation, and therapist´s supportive attitude were essential factors to this process.

The present diploma thesis deals with the self-disclosure of the psychotherapist during therapy. The theoretical section summarizes the present state of literature on the subject and current knowledge of the concept of self-disclosure. In order to grasp the topic more comprehensively, self-disclosure is viewed in the broader framework of psychotherapy. Furthermore, the thesis presents various ways of defining self-disclosure, dealing with the content and frequency of self-disclosure, the reasons for its use, as well as its risks and ethical aspects. The theoretical section is concluded with an overview of the concept of self-disclosure in terms of various therapeutic approaches. The empirical part of the thesis deals with the possibilities of dealing with the psychotherapist's self-disclosure during therapy. The qualitative research focuses on the ways in which psychotherapists use self-disclosure in their practice and on their experiences with this intervention. The data based on semi-structured interviews with nine psychotherapists are processed by the method of thematic analysis. The interviews' analysis results in the following main topics that are related to the treatment of psychotherapist self-disclosure during therapy: various types of self-disclosure; the psychotherapist's presetting for...