Experienced Psychotherapists Research Articles

Reliability of a measure of the quality of cognitive therapy.

This study investigates some of the psychometric properties of the Cognitive Therapy Scale (CTS) using a sample of experienced psychotherapists. Four raters, experienced in cognitive therapy, rated a total of 21 independent, videotaped psychotherapy sessions, and provided ratings along the dimensions of therapist competence measured by the CTS. Analyses included item intercorrelations, item-total correlations, and two assessments of inter-rater reliability. Inter-rater reliabilities showed a significant positive correlation for all items of the CTS and the internal reliability was strong. The potential of the CTS to address both the competency of cognitive therapists and trainees is discussed.

Concept of ego strength in psychotherapy.

The concept is discussed of how ego strength and equivalent dimensions of the term have been developed by well known contributors to psychotherapeutic literature and theory. A case is made for the translation of these dimensions, which include motivation and psychological mindedness, into operational terms and into items which are descriptive of the notion of personal and social competence. This has been done to provide guidelines for the assessment of patients for an optimal psychotherapy. A rationale for the inclusion for each item is constructed from the observations of experienced psychotherapists and research workers.

Employee With Multiple Sclerosis: Psychiatry in the Laboratory

Multiple sclerosis predominantly attacks educated women during their most productive years, with an incidence that makes it a predictable problem among laboratory technologists. Almost two thirds of the total unemployment of persons with MS traces directly to psychological factors. This article, a collaboration between two experienced psychotherapists, one a technician with MS, the other a pathologist and psychiatrist, presents a behavioral and a cognitive therapeutic repertoire and specific suggestions to improve and maintain the laboratory performance of personnel with MS. The psychological sequelae to organic disease (or fears of such), and steps for changing negative attitudes among personnel with MS, their peers, and supervisors receive particular attention. Such programs could reduce unjustified unemployment and make a humane contribution while adding expertise to the laboratory bench.

Evaluating the Competence of Psychotherapists

Pressure is increasing to develop methods for evaluating the competence of psychotherapists, not only in the field of education but also in clinical practice. The skills required of a psychotherapist have not yet been defined clearly, and are probably specific to kinds of patient and types of problem. However, there is a concensus that the capacity to establish a trusting relationship and to demonstrate concern, are essential. This relationship provides a "power-base" from which to influence the patient through a variety of elements which include "interpretation", modeling, and identification. Psychoanalysts assert that the "working through" of the transference is essential, but this is disputed by others. The evidence regarding the value of experience as a psychotherapist is unclear. Again there are conflicting reports. It appears that reasonable competence in technique can be acquired (through modeling) within the first year of training. It may be that the reason why experience does not emerge more strikingly as a positive factor, is that in the published material the more experienced psychotherapists treated the more difficult patients, and therefore the outcome of their treatment suffered. This paper touches on recent approaches at McMaster University to evaluate the competence of trainees; one by setting instructional objectives in family therapy, the other by means of a process analysis of videotaped interviews, in which residents and their supervisors participated. A single simulated patient was interviewed at two points in time, to indicate change and development in the psychotherapeutic techniques of the trainees.

Outcome in psychotherapy evaluated by independent judges.

To overcome common limitations in assessing the outcome of psychotherapy, the following method was used: independent assessment by teams of experienced psychotherapists; individualized measures of outcome; and videotaped clinical interviews to allow the judges to rate, at one sitting, a patient's clinical state before and after eight months of therapy. Agreement between the judges' ratings was low both for the severity of the clinical state and for its outcome. Possible reasons for this low agreement are discussed.

Psychotherapy in a psychiatric institution-attitude and process.

I have tried to demonstrate how experiences with individual psychotherapy and milieu work within a mental hospital, over a number of years, have brought about an increasing understanding concerning the basic importance of a therapeutic <i>attitude</i> by those working in mental health services, and also the importance of well trained psychotherapists as models and supervisors. Increasing insight into psychodynamic and social factors, have also contributed to a process within the institution. Individual psychotherapy in the hospital has met with its limitations, due to ego weakness on the part of the patients, the lack of experienced psychotherapists, and the necessity of integrating psychotherapy according to several other offers of treatment and rehabilitation. This development led to a reorganization of the whole treatment milieu, towards a more consequent group system, in which the total therapeutic resources, including patients and staff, have been utilized in a better way. Even this has met with its limitations, partly due to human irrationality and the complexity of group processes, and partly due to the limitations which are built into such a large hospital system and the resulting value conflicts. We now find ourselves at a third stage of development, in which the trend shifts towards more outpatient activity, and towards more work with patients’ families and their social situation.