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PubMed2003

Overcoming ambivalence: the challenges of exploring socially charged issues.

In this article, the author considers the challenges associated with the investigation of sensitive and socially charged issues. Drawing on a qualitative study of older women's body image and embodied experience, she discusses how societal ambivalence toward older women's bodies and appearances shapes and constrains the establishment of rapport between a young researcher and the study participants. Exploring the internalized anxiety expressed by the women, she investigates how life history narratives, multiple interviews, photographs, location of the interview, self-disclosure, information sharing, provision of assistance, student and stranger statuses, collaborative interviewing, and impression management combine to enhance rapport and ease the women's sense of discomfort.

Aged↗
PubMed2002

Interpersonal psychoanalysis' radical façade.

The participant-observation model initiated the relational turn, as well as the shift from modernism to postmodernism in psychoanalysis. This two-person, coparticipant conceptualization of the psychoanalytic situation moved psychoanalysis from the realm of alleged objective science toward intersubjectivity and hermeneutics. From this perspective, the analyst as subjective other is constantly engaged affectively with the patient in ways that are very often out of awareness. Analyst and patient both, for better or for worse, are believed to unwittingly influence one another. This description of the analytic dyad has led many to mistakingly conclude that interpersonal psychoanalysts advocate wittinly affective expressiveness, often in the form of deliberate self-disclosure of feelings, as part of a standard analytic stance. Upon closer examination, radical interventions are no more emblematic of interpersonal analysts than they are of analysts from most other traditions, though the interpersonalists have indeed expanded what had theretofore been a rather narrow repertoire of interventions.

Affect↗
PubMed1986

Can drugs be used to enhance the psychotherapeutic process?

Many preindustrial cultures traditionally use certain psychedelic plants to enhance a procedure that resembles psychotherapy--an idea that was also tested in Western psychiatry in the 1950s and 1960s. LSD and related drugs were used to facilitate the production of memories, fantasies and insights and to enhance the therapeutic alliance. The results were inconclusive, and research was largely abandoned after the drugs became difficult to obtain. It may now be possible to revive this research, using new drugs that do not have some of the disadvantages of the old ones. The drug now of most interest is MDMA (3,4-methylenedioxymethamphetamine) a relatively mild and short-acting substance that is said to give a heightened capacity for introspection and intimacy without the perceptual changes, emotional unpredictability, and occasional adverse reactions associated with LSD. Therapists who have used the drug claim that it can enhance the therapeutic alliance by inviting self-disclosure and promoting trust. Whether MDMA fulfills this promise or not, other drugs may eventually prove useful in psychotherapy. Research on their potential should not be curtailed because of fear that they will be subject to illicit abuse.

3,4-Methylenedioxyamphetamine↗
PubMed1998

Partners and fellow patients: two sources of emotional support for women with breast cancer.

This study examined the helping process that occurred when 26 breast cancer patients (the disclosers) talked about their illness-related concerns with their partner and, in a separate conversation, with a fellow patient (the volunteer helpers). The conversations were rated by trained observers and by the disclosers in terms of several process and outcome variables. From the observers' perspective, the volunteer helpers were more helpful, empathic, and supportive, less critical, and used more self-disclosure than the partners. Disclosers did not differentiate between the two types of helper, and gave generally high ratings to both conversations. Strengths and weaknesses of each type of helper were identified. Findings are discussed in relation to the literature on formal and informal helping, and implications for training nonprofessional helpers are suggested.

Adult↗
PubMed1992

[Looking into the past. Psychological and gerontologic aspects of memory].

Reminiscence is characterized by a dialectical relation of past and present which is of fundamental importance for personal identity. Moreover, it shows a double aspect, implying both the private recollection of one's past and the social dimension of narration, instruction and self-disclosure. This will be illustrated by a consideration of the different forms and functions of reminiscence in general, and by the results of research on the role of reminiscence in later life. An investigation into these aspects of reminiscence may also further a therapeutic approach to the crises resulting from unresolved conflicts in the life history.

Aging↗
PubMed2006

Boundaries & adolescents in residental teatment settings: what clinicians need to know.

Working with adolescents in psychiatric treatment settings poses unique challenges related to boundaries. Staff are typically from a range of disciplines, and some are from nonregulated professions. Three potential boundary-crossing areas are touching, gift giving, and self-disclosure. To enhance quality of care, staff needs an orientation aimed at boundary education, including the concepts of transference and countertransference; an atmosphere of safety to discuss their observations of themselves and others; to be willing to provide feedback; and a sound knowledge base of adolescent growth and development.

Adolescent↗
PubMed1999

[To know that the physician is really listening].

Communication is a central feature of patient-doctor interaction, and one that is often problematic. Listening is so basic that we tend to take it for granted. Unfortunately, most of us think ourselves better listeners than we really are. Especially distressing are deaf ears among those we count on for understanding. Doctors are powerful social figures, expected to manifest appropriate skills in encountering anxious, unhappy, disappointed, angry or even hypochondriac patients. The article consists in a review of an interview method based on cognitive principles, specially designed to promote the patient's feeling of being listened to, and to establish a working relationship. Such skills as non-verbal communication, reflection, summation, and self-disclosure are essential components of the method. The patient's emotional response to health problems is viewed as being valid, and investigation is initiated on the basis of the patient's perception of the problem rather than on the doctor's professional knowledge. Through Socratic questioning, the doctor helps patients to reach their own conclusions and to reformulate axiogenic hypothesis.

Clinical Competence↗
PubMed1988

Interactions of depressed college students with their roommates: not necessarily negative.

Coyne's (1976b) interactional theory of the social environment's role in maintaining depression suggests that depressed people create negative affect in others. This leads to a pattern of interactions between depressed individuals and others that is aversive to both parties and becomes a vicious circle. We examined interactions of 15 depressed and 15 nondepressed college students with their roommates. On questionnaires, roommates did indicate more rejection, dislike, and avoidance of the depressed students than of the nondepressed students, consistent with Coyne's theory, and depressed-student-roommate interactions were more personally involved (higher percentage of self-disclosure) and less positive than nondepressed-student-roommate interactions. The moods of both depressed students and their roommates were worse than those of controls before the interaction but, contrary to expectation, improved over the course of the interaction, whereas the moods of nondepressed students and their roommates did not change significantly. Implications of these results for Coyne's theory are discussed.

Adolescent↗
PubMed1982

Clinical relevance of the Marlowe-Crowne Scale: a review and recommendations.

Research is reviewed which indicates the potential utility of the Marlowe-Crowne Social Desirability Scale (MCS) in a variety of clinical assessment contexts. In relation to other assessment devices, the MCS has been used to enhance predictive accuracy of several scales, and has predicted defensive reactions to negative personality test feedback. Research is also reviewed regarding MCS relationships to self-disclosure, therapy process variables, premature termination from psychotherapy, and selection of subjects for psychotherapy research. The role of the MCS as a therapy outcome measure is also discussed. Scoring norms for normal and clinical groups are presented, including discussion of the effects of age, education and race on MCS scores. A number of avenues for future research with the MCS are described.

Adult↗
PubMed1981

Therapeutic factors in group psychotherapy. A review.

This is a review of theoretical, empirical, and clinical research on therapeutic factors (TFs) in group psychotherapy covering the period 1955 to 1979. Therapeutic factors are processes that contribute to improvement in the patient's condition; they are different from conditions for change and from techniques. The following TFs are examined: self-disclosure, interaction, acceptance (cohesiveness), insight, catharsis, guidance, altruism, vicarious learning, instillation of hope, and an existential factor. Criteria for adequate experimental design in group research are proposed. About 40% of the works reviewed contain empirical studies; the quality of these studies is variable both conceptually and methodologically. It is difficult to assess the extent to which clinical practice has actually been influenced by this work on TFs.

Catharsis↗
PubMed2004

Intimacy expectations in same-sex friendships: a prototype interaction-pattern model.

A prototype interaction-pattern model of intimacy expectations was proposed. The central tenet of this model was that people develop knowledge of the patterns of relating that are likely to produce intimacy in a same-sex friendship. Further, it was posited that these interaction patterns are structured as prototypes, such that some patterns of relating are regarded as more likely to create a sense of intimacy than others. Support for this model was found in 6 studies. Interaction patterns depicting self-disclosure, emotional support, and the like were considered more prototypical of intimacy expectations than patterns depicting shared activities and practical support. Regarding gender, women rated intimacy interaction patterns higher than did men, particularly prototypical patterns. However, women and men agreed that prototypical interaction patterns were more indicative of intimacy in a friendship than nonprototypical patterns. Implications for the controversy over whether women's friendships are more intimate than men's are discussed.

Adolescent↗
PubMed2006

Prevalence and correlates of HIV serostatus disclosure: a prospective study among HIV-infected postparturient women in Barbados.

This study was undertaken to determine the prevalence of self-disclosure of HIV status among the postparturient HIV-infected women and to describe the correlates of disclosure in this population. Subjects for this study include all known HIV-infected postparturient women in Barbados who delivered during 1997 through 2004. Sociodemographic data are routinely collected from all HIV-infected postparturient women. Data on disclosure were collected through one-to-one interview of the consenting women included in this study. One hundred thirtynine women were studied. Forty women (28.8%) had self-disclosed their HIV status to other people including their current sex partner. Among women who did not disclose their HIV status to anybody, 30 (30%) gave fear of stigmatization as the reason for nondisclosure, while 23 (23%) did not disclose their status as they feared abnormal reaction from their current sex partner and possible violence directed at them. Women who had disclosed their HIV status were more likely to use condoms during all sexual encounters, less likely to have had subsequent pregnancy from a different sex partner, were more likely to have a partner who had been tested for HIV, and were themselves more likely to be attending the centralized HIV clinic for follow-up and care compared to those who did not disclose. A substantial proportion of HIV-infected postparturient women never disclosed their result to a partner or a close relative. Lack of disclosure may have limited their ability to engage in preventive behaviors or to obtain the necessary emotional support for coping with their serostatus or illness.

Adult↗
PubMedDate not supplied

The autobiographical group: a tool for the reconstruction of past life experience with the aged.

From a personal construct point of view, writing autobiographical texts becomes a relevant therapeutic ingredient for elderly individuals. If conducted in a context of a group, as Birren proposes [1, 2]; it promotes self-awareness, self-disclosure, and the capacity of generating alternative views of life's experiences. In a group of elderly volunteers from a recreational society of Barcelona (Spain), the guided autobiography method was used to foster the reconstruction of the participant's past life experiences. The degree of reconstruction was assessed through a design that included the administration of a repertory grid at the initial and tenth (last) session. A parallel assessment was applied to a control group of participants with similar demographic characteristics. An adaptation of the method proposed by Feixas for the analysis of autobiographical texts was used to assess the assigned writings of the participants for each session. Results show a significant and gradual change in the construing system of those participants in the autobiographical group. Thus, the distance of the elements self-ideal/self and self-ideal/others significantly decreased in comparison to the control group. It is suggested that the guided autobiography is an adequate therapeutic tool to promote the reconstruction of experience in aged individuals.

Aged↗
PubMed1985

Family interaction patterns among Japanese-American and Caucasian families in Hawaii.

The authors compared the family interaction patterns of Japanese-American and Caucasian families in Hawaii by rating videotapes of structured family interactions. There were significant differences between the two groups in many aspects of family interaction, such as power, coalition, closeness, negotiation, clarity of self-disclosure, responsibility, invasiveness, affect, and empathy. The differences in family interaction could be explained by the cultural differences between the two groups and indicate that profiles of healthy families differ between distinct cultures, and there is a need to establish a culturally relevant family interaction profile; otherwise normal interactions in families outside the mainstream could be misinterpreted as pathological.

Adolescent↗
PubMed1990

Nonverbal behavior and client state changes during psychotherapy.

In an intensive videotape analysis of 10 psychotherapy sessions, the body positions and gesticulation patterns of the client were examined in relation to changes in her verbal behavior. Verbal ratings were obtained on the Experiencing Scale (Klein, Mathieu, Gendlin, & Kiesler, 1970), and nonverbal ratings were obtained on the Davis Nonverbal States Scales (Davis, 1986). Results revealed that the position "accessibility" ratings were related significantly to levels of self-disclosure and involvement as determined by the verbal ratings. The client's gesticulation ratings were not related significantly to the Experiencing Scale ratings, but clinically interesting relationships between gesticulation patterns and verbal content were noted. While body movement long has been recognized as an important source of clinical information, replicable coding of complex patterns of position and gesture has been very difficult to develop. This study presents data that support a promising, replicable method for coding nonverbal behavior in psychotherapy process research.

Adult↗
PubMed1986

Personal themes from training groups for health care professionals.

The personal themes presented by 210 health care professionals in the training group component of an annual group psychotherapy course are described. The course, begun in 1976, provides inexperienced group leaders with an introduction to theory and a personal group experience in 12 weekly sessions. Within this brief period, the development of a cohesive working group is possible. Members have revealed much personal tragedy which cannot be expressed at work for fear of being thought weak. At times in their clinical work members have felt helpless and hopeless. Giving care and not receiving it has been a burden. The group experience has allowed members to transcend professional rivalries and see each other as people and not in stereotype. Members have often feared damaging their careers by self-disclosure and, for some, the group has provided the first opportunity for intimate dialogue with colleagues. The groups have supported members through personal crises and helped them make career decisions. The results highlight the value to staff of having a safe, non-punitive group setting in which they may speak of personal issues that trouble them, begin to become aware of how their own personality and life experience may impair and enrich their ability as therapists, and surmount the obstacle of stereotyping to meet their colleagues in dialogue.

Decision Making↗
PubMed2006

Confidentiality and privileged communication in group psychotherapy.

The concept of confidentiality is fundamental to all forms of psychotherapy. The idea of protecting confidential material goes as far back as the Hippocratic Oath in ancient Greek history. Centuries later, authors continue to assert that "only by maintaining confidentiality can the essential groundwork of trust in treatment be developed" (Hough, 1992, p. 106). Others have even argued that without confidentiality, psychotherapy has no value (Epstein, Steingarten, Weinstein, & Nashel, 1977). Confidentiality in group psychotherapy is more complicated than in individual therapy because self-disclosure is at the core of group therapy and there are numerous people hearing the disclosures. Confidentiality in group therapy, once ignored in the literature on ethics, is gaining more attention as this modality becomes more widely practiced; so too is an acknowledgement that ethical dilemmas surrounding confidentiality in groups are commonplace. This article discusses the major considerations and dilemmas on confidentiality in group psychotherapy. We first review confidentiality broadly and discuss the ethical principles that are related to confidentiality. In the next section, we discuss the complexities of confidentiality in group psychotherapy. Finally, we review research on confidentiality in groups and describe common ethical dilemmas.

Communication↗
PubMed1990

Psychiatric nurses' and patients' perceptions of discussion topics in therapeutic groups.

Discussion topics for outpatient group therapy sessions were rated for importance by 84 psychiatric outpatients from 6 therapeutic groups and 26 psychiatric nurses. Topics were measured by scales of personal problems and feelings, lifestyle, response to health care, and nonhealth self-disclosure. No significant differences in importance ratings among therapeutic groups or between nurses and patients were found. Scale rankings were the same among patient groups and between nurses and patients, with personal problems and feelings receiving the highest score. Results support the existence of a common goal implicit among therapeutic groups that is known by nurses and augurs well for group cohesion, behavior in accordance with norms, and the efficacy of nurses as leaders of therapeutic groups.

Goals↗