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Results for “Countertransference”

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PubMed2001

Sex offender treatment: therapists' experiences and perceptions.

The literature portrays work with sex offenders as mentally, physically, and emotionally draining. However, the therapists working in the outpatient Sexual Abuse Treatment (SAT) program at a regional mental health center, while not denying the challenges of this work, describe their experiences as generally positive and rewarding. Because these therapists' experiences seemed to contrast with the literature, a qualitative descriptive study was conducted to examine the SAT therapists' experiences and perceptions. Seventeen SAT therapists were individually interviewed. Interviews were audio taped, transcribed verbatim, and analyzed using constant comparative analysis. The therapists in this study indicated that although sexual offender treatment is a stressful area to work in, it offers many rewards and is viewed as "a challenge and privilege." Exploring the positive as well as the negative impacts of working with sex offenders may help identify additional coping strategies or mediating factors for this challenging work.

Adult↗
PubMedDate not supplied

Ten common errors beginning substance abuse workers make in group treatment.

Beginning therapists sometimes make mistakes when working with substance abusers in groups. This article discusses ten common errors that the author has observed. Five center on the therapist's approach and five center on the nuts and bolts of group leadership. Suggestions are offered for how to avoid them.

Attitude of Health Personnel↗
PubMed1997

Psychodynamic psychotherapy for cancer patients.

Psychodynamic psychotherapy is effective as an approach to understanding the psychological conflicts and the psychiatric symptoms of cancer patients as well as to planning useful psychological interventions. The author recommends that the psychotherapist who treats cancer patients be familiar with the following: 1) the natural course and treatment of the illness, 2) a flexible approach in accord with the medical status of the patient, 3) a common sense approach to defenses, 4) a concern with quality-of-life issues, and 5) counter-transference issues as they relate to the treatment of very sick patients. Case reports illustrate the unique problems facing psychotherapists who are treating cancer patients. Further, these cases show the effective use of psychodynamic principles to inform the therapist of successful psychotherapeutic interventions.

Adult↗
PubMedDate not supplied

Borderline personality disorder, stigma, and treatment implications.

Borderline personality disorder (BPD) is often viewed in negative terms by mental health practitioners and the public. The disorder may have a stigma associated with it that goes beyond those associated with other mental illnesses. The stigma associated with BPD may affect how practitioners tolerate the actions, thoughts, and emotional reactions of these individuals. It may also lead to minimizing symptoms and overlooking strengths. In society, people tend to distance themselves from stigmatized populations, and there is evidence that some clinicians may emotionally distance themselves from individuals with BPD. This distancing may be especially problematic in treating patients with BPD; in addition to being unusually sensitive to rejection and abandonment, they may react negatively (e.g., by harming themselves or withdrawing from treatment) if they perceive such distancing and rejection. Clinicians' reactivity may be self-protective in response to actual behavior associated with the pathology. As a consequence, however, the very behaviors that make it difficult to work with these individuals contribute to the stigma of BPD. In a dialectical relationship, that stigma can influence the clinician's reactivity, thereby exacerbating those same negative behaviors. The result is a self-fulfilling prophecy and a cycle of stigmatization to which both patient and therapist contribute. The extent to which therapist distancing is influenced by stigma is an important question that highlights the possibility that the stigma associated with BPD can have an independent contribution to poor outcome with this population. A final issue concerns the available means for identifying and limiting the impact of stigmatization on the treatment of individuals with BPD.

Borderline Personality Disorder↗
PubMed2004

What can we learn from the therapist's body?

I suggest a re-theorization of the relationship between psyche and soma in which the body is no longer seen as 'mere' receptacle for unwanted contents of the mind but in which a body subjectivity has a developmental history in its own right. I argue that the body has its own history arising out of the attachment nexus and the internalization of the bodies of its caregivers and the bodies they are able to recognize in their infants and children. I illustrate the way developmental body issues appear in the clinical setting and how the therapist's body can be used to locate and identify the troubled bodies of our clients. A long history of work with women with eating problems and troubled bodies shows that bodies are not born but are acquired in relationship with key caregivers.

Countertransference↗
PubMed2006

Therapists' emotional reactions to patients as a mediator in cognitive behavioural treatment of panic disorder with agoraphobia.

The aims of this study were to examine whether therapists' emotional reactions to their patients mediate the effect of personality disorders and interpersonal problem behaviours on the outcome of treatment, focusing on an Axis I disorder; and whether therapists' reactions mediate the effect of personality disorders on the course of interpersonal problems. Therapists completed a checklist of emotional reactions to individual patients after the end of residential cognitive or guided mastery therapy for 46 inpatients with panic disorder with agoraphobia. The severity of DSM-III-R personality disorder was related to therapists' insecurity feelings, but not to interest and anger. A higher level of therapists' insecurity feelings was related to less reduction in self-reported agoraphobic avoidance during treatment, whereas therapists' emotions were unrelated to symptomatic course after treatment. Therapists' insecurity feelings appeared partly to mediate the relationship between patients' severity of personality disorder and persistence of patients' interpersonal dominance and nurturance problems.

Adult↗
PubMed2004

Establishing and running a trauma and dissociation unit: a contemporary experience.

OBJECTIVE: To evaluate the functioning of a trauma and dissociation unit that has run for the past 8 years in a private hospital, with particular regard to operating philosophy, operating parameters, challenges encountered, research and educational initiatives, and the applicability of the treatment model to other settings. CONCLUSIONS: Despite the challenges associated with significant difficulties in the corporate management of a private health-care system, it has been possible to operate an inpatient and day hospital programme tailored to the needs of patients in the dissociative spectrum, and the lessons learnt from this experience are valid considerations in the future planning of mental health services overall.

Cooperative Behavior↗
PubMed2005

Owning the past, claiming the present: perspectives on the treatment of dissociative patients.

OBJECTIVE: From the early 1990s there has been a growing awareness in Australia of dissociative processes and dissociative disorders. The objective in this paper is to provide a selective overview of the context and process of treatment based on the substantive dissociative disorders literature, ongoing clinical experience and research, and over 8 years as director of a trauma and dissociation unit at Belmont Hospital, Brisbane. CONCLUSIONS: The construct of individual selfhood is of direct relevance in illustrating the psychological damage sustained by patients who have relied on dissociative defences to survive, and in highlighting issues and areas that are a particular focus of informed treatment.

Adult↗
PubMed2005

Power and knowledge in psychiatry and the troubling case of Dr Osheroff.

OBJECTIVE: To consider the state of knowledge in psychiatry with reference to the 'Osheroff debate' about the treatment of depression. METHOD: A review of the key philosophical issues regarding the nature of knowledge applied to the Osheroff case. RESULTS: There is an apparent dichotomy between knowledge derived from a reductionist scientific method, as manifest in evidence-based medicine, and that of a narrative form of knowledge derived from clinical experience. The Focauldian notion of knowledge/power and knowledge as discourse suggests that scientific knowledge dominates over narrative knowledge in psychiatry. The implication of this applied to the Osheroff case is the potential annihilation of all forms of knowledge other than science. CONCLUSIONS: Knowledge in psychiatry is a pluralist, rather than singularly scientific enterprise. In the Osheroff case, the potential for scientific knowledge to abolish other forms of knowledge posed a serious threat of weakening the profession. In the light of the current debate about best practice, there is a need for reconsideration of the implications of Osheroff.

Antidepressive Agents, Tricyclic↗
PubMed1977

Psychotherapy and physical therapy common grounds.

Psychotherapy and physical therapy involve charged emotional relationships with many common features. Understanding of these common elements can help physical therapists to work with their patients, to utilize the healing aspects of the relationship, and to reduce the tensions within the relationships that can interfere with job satisfaction. The importance of separation and its management are emphasized.

Acting Out↗
PubMedDate not supplied

Supervision as professional development for psychiatric mental health nurses.

Clinical supervision is an essential element in the professional development of advanced practice psychiatric mental health nurses, and many interpersonal approaches exist to facilitate this process. This article discusses the issues underlying supervision, the key elements of the supervision process, and the current literature focused on the development of best practices in the conduct of clinical supervision. Recommendations for the implementation of supervision are identified.

Benchmarking↗