Patterns of patient disclosure in psychotherapy.
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Biomedical subjects
Publications and source records attributed to B A Farber.
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This study investigated differences in extent and patterns of disclosure in psychotherapy between American (n = 164) and Israeli (n = 45) patients. Participants completed the Disclosure to Therapist Inventory-R, an 80-item measure that uses a rating scale to assess the extent to which psychotherapy patients have discussed each of 80 moderately to highly intimate topics with their most recent therapist. Analysis yielded no significant difference between groups in overall disclosure and high overlap in the topics most and least discussed. Both groups frequently discussed aspects of their personalities they disliked, feelings of desperation or depression, and feelings of rage or anger towards parents. Findings suggest universal concerns may outweigh the cultural context in which therapy occurs.
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Using teachers as a prototype, this article suggests that there are three types of burnout: "wearout," wherein an individual gives up, feeling depleted in confronting stress; "classic" burnout, wherein an individual works increasingly hard in the face of stress; and an "underchallenged" type, wherein an individual is faced not with excessive degrees of stress per se (e.g., overload), but rather with monotonous and unstimulating work conditions. The major arguments put forward are that: a) clinicians should avoid treating teacher burnout as if it were a single phenomenon, and instead tailor their treatment to the specific type of burnout manifested by their client; and b) these treatments, while embodying different elements, should be essentially integrative in nature. Psychoanalytic insight, cognitive restructuring, empathic concern, and stress-reduction techniques may all be necessary, albeit in different combinations, to treat successfully burnout of each type.
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OBJECTIVE: To better understand how neighborhood and individual factors are related to child maltreatment. METHOD: Using an ecological framework, a multi-level model (Hierarchical Linear Modeling) was used to analyze neighborhood structural conditions and individual risk factors for child abuse and neglect. Parents (n = 400) of children under the age of 18 were systematically selected from 20 randomly selected census-defined block groups with different risk profiles for child maltreatment report rates. Parents were administered the Neighborhood Environment for Children Rating Scales, the Child Abuse Potential Inventory, the Zimet measure of social support, and the Conflict Tactics Scales as a measure of childhood experience with violence. RESULTS: Neighborhood factors of improverishment and child care burden significantly affect child abuse potential after controlling for individual risk factors. However, neighborhood effects are weaker than they appear to be in aggregate studies of official child maltreatment reports. Variation in child abuse potential within neighborhoods is greater than between neighborhoods. However, adverse neighborhood conditions weakened the effects of known individual risk and protective factors, such as violence in the family of origin. CONCLUSIONS: If individual potential for child maltreatment is more evenly distributed across neighborhoods than reported maltreatment, then neighborhood and community play an important, if as yet unspecified, role in child maltreatment. Multi-level models are a promising research strategy for disentangling the complex interactions of individual and contextual factors in child maltreatment.
The nature and origins of the current tendency toward disparaging parents and teachers of the urban poor are examined. It is suggested that the influence of parents and teachers must be understood in the context of multiple intervening variables. Several explanations are offered for the phenomenon of blame, including the fact that women constitute the great majority of teachers and are often the primary agents of parenting.
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We tested the hypothesis that highly psychologically minded individuals perceive having grown up with rejecting parents. A Psychological Mindedness (PM) Scale, and the Parent-Child Relations Questionnaire II (PCR), were administered to 120 college students. Contrary to prediction, a significant negative correlation was found between PM and perceptions of early maternal rejection. Psychological-mindedness, it was suggested, may be attributable to "good enough mothering" and may be learned through modeling and imitation of mothers' empathic perceptions, affective responses, and behavior.
Examined the impact of patient diagnosis on countertransferential responses to hypothetical latency-aged child psychotherapy patients meeting criteria for Dysthymia, Conduct, and Borderline Disorders. Three subtypes of countertransference (CT) were measured: positive (e.g., nurturant feelings), negative (e.g., boredom), and CT-related activity (e.g., tendency to refer patient to another therapist). All three subtypes were found to vary significantly as a function of diagnosis. Of the three diagnostic groups, Dysthymic patients elicited the highest degree of positive CT; Conduct Disorder patients, the highest degree of negative CT; and Borderline patients, the highest degree of CT-related activity. Neither patient and therapist gender nor therapist experience was significantly related to any of the CT scores; however, therapist psychological distress was found to be significantly associated with negative CT and CT-related activity for all three diagnoses.
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Using a cross-sectional design, the forms, functional themes, and corresponding affects of clients' (n = 88) representations of their therapists were compared across three distinct time phases of therapy: up to one year, between one and three years, and more than three years. Results indicated that clients in the beginning phase of therapy were less likely to employ representations in the service of continuing the therapeutic dialogue in-between sessions, and less likely to use representations to relieve the pain associated with missing the therapist during separations than clients who have been in therapy for more than one year. Clients in all three phases of therapy most commonly felt comforted and accepted when evoking therapist representations in between sessions.
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The primary aim of this study was to assess whether the capacity for self-reflection in late adolescent females is related to their level of identity development. It was hypothesized that females characterized by advanced identity status (either identity achievement or moratorium) would exhibit a greater capacity for self-reflection than those characterized by less advanced identity status (foreclosure or diffusion). Of 85 subjects who met the criteria for this study (female college students in the New York City area), 32 fit purely into one of four identity statuses; among this latter group, a t test revealed a significantly higher degree of self-reflection for the advanced identity status subjects. Implications for the psychology of identity are discussed.
This reexamination of the values underlying Behavioral Marriage Therapy (BMT) focuses on the central theoretical concept of reciprocity. It is suggested that BMT's emphasis on individuality and instrumental exchange may not be suitable for all couples. An alternative perspective, emphasizing a developmental progression in marriage reciprocity defined by mutual understanding, is seen to be more sensitive to the differing value systems of couples in therapy.