Therapist Visits Research Articles

Psychotherapy With Gay Men and Lesbians: Contemporary Dynamic Approaches

Back to table of contents Previous article Next article Book ReviewsFull AccessPsychotherapy With Gay Men and Lesbians: Contemporary Dynamic ApproachesSki Hunter, Ph.D.Ski HunterSearch for more papers by this author, Ph.D.Published Online:1 Sep 2004https://doi.org/10.1176/appi.ps.55.9.1073AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail The chapters in this book, previously published in the Journal of Gay and Lesbian Psychotherapy, address practice with lesbian, gay, and bisexual clients. In addition to an introduction by the editors, the book has four sections: "Gay Patient-Gay Therapist," "Erotic Transference/ Countertransference," "Gender Identity and Creativity," and "Two Cases of Psychotherapy With People with HIV/AIDS." The contributors include faculty members in universities or institutes, members of editorial boards of journals, and private practitioners. The focal interest of all the contributors is psychotherapy and psychoanalysis.Key themes of Psychotherapy With Gay Men and Lesbians: Contemporary Dynamic Approaches include whether there is a lesbian, gay, and bisexual therapy; whether a therapist's sexual orientation makes for a type of therapist; changing views of categories such as lesbian and gay (what do they really mean in changing cultural contexts?); gender and sexuality (are we passing for a certain gender or sexual orientation?); essentialism and constructionism; postmodernism (for example, subjectivity, such as one's values and attitudes, is part of the therapeutic process); the interpretative subjects of therapist and client; whether the therapist should take the same risks asked of clients, such as discussing with clients one's emotions and feelings; relational psychotherapy; countertransference; negative transference; erotic transference in same-sex therapeutic dyads; self-disclosure by therapists (for example, sexual orientation and experiencing sexual feelings for clients); and other boundary issues.This book essentially represents contemporary and developing views of psychoanalysis versus the old or traditional views, which, for example, were moralistic and judgmental of lesbian, gay, and bisexual clients. Other examples include subjectivity (versus objectivity) and transference-countertransference (versus being seen as neurotic). These phenomena are now seen as having a legitimate place in the foreground of therapy. A theme present throughout the chapters is what is happening to the therapist during therapy. Sexual issues are particularly grappled with, such as whether a therapist should disclose his or her sexual reactions to a client. One of the case studies involving a client with AIDS raises another boundary issue in the context of a client who is seriously ill and hospitalized. Should the therapist visit the client? There is also the provocation when working with these clients for a therapist in terms of his or her own mortality, potential future illnesses, and losses. Are these issues to be kept in the background, or disclosed to the client?The editors' purpose was to have the book's contributors discuss contemporary issues in psychotherapy with lesbian, gay, and bisexual clients. The book looks at the relationship going on in therapy between the therapist and the client and the complicated issues that occur. In addition, thinking outside the box is evident on many topics, including gender, sexual orientation, subjectivity, and countertransference. The book's value lies in the discussions and critiques of how these and other issues get played out in therapy. Many of the issues are contentious and thus are not settled. Agreements and disagreements are evident.Dr. Hunter is affiliated with the School of Social Work at the University of Texas at Arlington.edited by Jack Drescher, Ann D'Ercole, and Erica Schoenberg; New York, Harrington Park Press, 2003, 258 pages, $24.95 softcover FiguresReferencesCited byDetailsCited ByNone Volume 55Issue 9 September 2004Pages 1073-1073 Metrics PDF download History Published online 1 September 2004 Published in print 1 September 2004

Impact of Methadone Program Philosophy Changes on Early Treatment Outcomes

This paper describes the consequences of changing from methadone maintenance treatment focussed primarily on elimination of all illicit drug use and social reintegration to patient-centred care. Counselling (formerly mandatory) became optional, patients were retained in treatment despite continued illicit drug use, the ceiling on methadone doses was removed, patient input became a part of methadone prescribing and the number of patients in treatment more than doubled. Across three cohorts (before, during and after the program was redesigned) the mean daily dose of methadone increased (50.4 mg ± 2.5, 72.6 mg ± 2.4, 92.2 mg ± 4.0, respectively). The number of physician visits increased linearly with cohort while the number of therapist visits was unchanged overall. Two-year treatment retention was not significantly different (73%, 69% and 67%, respectively). In all three cohorts there was a significant reduction in opioid and benzodiazepine use but not cocaine use over the first six months of treatment.

Therapy With Children Now Part of a Dog’s Life

Therapy With Children Now Part of a Dog’s Life

An Investigation of Involvement in Leisure Activities After a Stroke

The purpose of this study was to determine the efficacy of occupational therapy intervention related to the leisure activities of stroke survivors. Forty discharged stroke patients were randomly assigned to an experimental group, which received occupational therapy intervention related to leisure activities, or to a control group. An independent evaluator assessed the patients' involvement in activities and satisfaction with that involvement on three separate occasions. The results showed no statistically significant differences between the experimental and control groups in activity involvement or satisfaction with that involvement. There are likely two reasons for these findings. First, the intervention was limited in scope (i.e., only five therapist visits), and second, many environmental factors strongly influence activity participation and satisfaction.

Treatment of Primary Enuresis in a Mentally Retarded Adult: The Need to Supplement The Bell and Pad Procedure

Bell and pad intervention to treat enuresis in a 21 year old mentally retarded male, living in a half-way house for intellectually handicapped people, is reported. Enuresis was not significantly reduced after 22 weeks of standard bell and pad treatment. Therapist involvement in the programme was de-emphasized to offset the possibility that therapist visits were reinforcing wet nights. This de-emphasis was supported by behavioural contracting. These programme supplements were associated with an immediate reduction to no wet nights. A six month Follow-up revealed the subject had wet his bed only very occasionally. No “symptom substitution” was evident.

Early referral to limb deficiency clinics.

Immediate support is needed by parents when a limb deficient child has been delivered, a time when parents' fears and problems are greatest. This support involves special skills not readily available in the community. Thus it is important that these children and their parents are referred to Specialist Clinics by their local doctor immediately after birth. Experienced therapists and medical social workers attached to these clinics are not normally available to obstetric specialists and general practitioners. The doctor-in-charge of the Clinic, the social worker and the therapist visit the parents and child in hospital. This early counselling facilitates the bonding of the parents and child. It also reduces the parents feelings of guilt and distress over having a deformed baby. Appropriate counselling given at this stage on prostheses, daily living activities, parent group discussions and the future prospects for these children, helps ensure a satisfactory life.