Counseling Process and Outcome

The study aimed to investigate the benefits of Gestalt counselling techniques in assisting students in addressing peer relationship issues at a public university. Specifically, the study examined the use of the empty chair and body language Gestalt counselling techniques in assisting students with peer relationship challenges, employing a hermeneutic
phenomenological approach. An expert purposive sampling method was employed to select four counsellors and criterion purposive sampling for the sixteen students who had received counselling that utilised the empty chair and body language Gestalt techniques. Data was collected through semi-structured interviews and retrospective record reviews and subsequently analysed thematically. The results revealed that the majority of clients reported positive progress and were able to overcome their relationship challenges, while some experienced difficulty in engaging with the techniques. Factors contributing to the benefits of the empty chair technique included counsellor proficiency, the client's ability to employ their imagination, and the client's readiness to participate in the technique. Instances where the technique was less successful often stemmed from clients feeling uncomfortable with the method. The empty chair counselling technique was most employed in cases involving rejection, unresolved relationship challenges, the need for emoting, as well as intra and interpersonal conflicts. More findings showed that body language counselling techniques played a crucial role in the interaction between counsellors and clients, influencing the effectiveness of the counselling process. Positive results indicated that both counsellors and clients benefitted from enhanced communication and gained additional insights beyond verbal expressions, leading to increased awareness. Despite this, some participants experienced challenges and discomfort when the counsellor pointed out their body language. The study recommends that counsellors utilizing the empty chair technique and body language receive
comprehensive training to enhance their benefits and ensure a comfortable experience for clients. Moreover, counsellors should incorporate culturally sensitive strategies when utilizing body language to enrich the counselling process

In this essay I outline the role that ethics and boundaries hold in counselling and psychotherapy. I discuss ethics in counselling, ethics of different approaches, and ethics of a professional organisation. I then discuss professional boundaries in counselling and psychotherapy.

Die Verständigung über Krankheitstheorien gilt im medizinischen und psychotherapeutischen Kontext als wichtiger Bestandteil der Herstellung eines Arbeitsbündnisses und damit als Voraussetzung für eine erfolgreiche Behandlung. Als besonders relevant erweist sich die Einbeziehung von Subjektiven Krankheitstheorien (SKT) und Kausalattributionen (die als Kernbestandteil von SKT definiert sind) bei Patient/innen mit "medically unexplained symptoms" (MUS), d.h. Körperbeschwerden, für die kein eindeutiger somatischer Befund vorliegt und psychosomatische Erklärungen in Betracht zu ziehen sind. Die Bereitschaft für eine psychotherapeutische Mitbehandlung setzt bei Patient/innen nicht nur eine prinzipielle Anerkennung psychosomatischer Zusammenhänge voraus, sondern auch die Bereitschaft, psychosomatische Erklärungen für die eigenen Beschwerden in Erwägung zu ziehen. Die Akzeptanz dieser Zusammenhänge steht jedoch einerseits in einem Spannungsfeld von sozialen Legitimierungsproblemen und Stigmatisierungsbedrohungen und wird andererseits dadurch erschwert, dass psychosomatische Zusammenhänge nicht mit den üblichen medizinischen Diagnosemethoden "sichtbar" gemacht werden können. Das vorliegende Arbeitspapier basiert auf einem Korpus von 44 Therapiegesprächen mit 10 Patient/innen mit MUS, die sich zur somatischen Abklärung stationär im Krankenhaus befanden und die zu Gesprächen mit hinzugezogenen Psychotherapeut/innen bereit waren. Unsere Analysen konzentrieren sich auf die interaktive Bearbeitung von Kausalattributionen (als zentralem Element jeder SKT) durch die Patient/innen und Psychotherapeut/innen unter den besonderen Bedingungen von MUS. Dabei wird ein rekurrentes Verfahren in den Fokus genommen, bei dem sich der Umgang mit dem Nicht-Wissen (der Beschwerdeursache) als Suchbewegungen beschreiben lässt, in denen einerseits eine große Offenheit für Kausalattributionen zum Ausdruck gebracht wird, andererseits aber das Nicht-Wissen aufrecht erhalten bleibt. Das interdisziplinär zusammengesetzte Autorinnenteam einer Linguistin und einer Psychologin nutzt als methodischen Bezugsrahmen die konversationsanalytisch geprägte Gesprächsforschung.

The development of conduct disorder is linked to an interaction of various factors. Although some children will manifest with symptoms such as aggression, rebellion and emotional problems before the age of ten, conduct disorder occurs mostly from ten years and above. The purpose of this study was to establish some of the distressful events children with conduct disorder may have experienced. The study focused on identifying the association between exposure to distressful situations such as domestic violence, child abuse, death of a parent and the risks of developing conduct disorder. A total of 167 respondents aged between 13 and 17 years from Kabete and Wamumu rehabilitation schools in Kenya participated in this crosssectional study. A self-administered questionnaire and Child Behavior Checklist Youth Self Report for ages (11-18) (2001) were administered. Data was analysed using Statistical Package for the Social Sciences version 20.0 (2011). The prevalence of conduct disorder was 36.4%, while 71.9% of the respondents were found to have witnessed violence within their neighborhood. Additionally, 68.9% of the respondents found people in their neighborhood hostile to them, 62.9% felt neglected by their parents or caregivers, and 58.1% had parents who abused alcohol. Furthermore, 54.5% of the respondents reported that their parents or caregivers punished them with beatings, while 53.9% had been emotionally abused by their parents or caregivers. Out of the distressful events variables investigated for association with conduct disorder, parents or caregivers fighting with weapons and witnessing parents or caregivers fight physically at home had a strong link. Moreover, respondents whose parents or caregivers abused alcohol or who were neglected had higher risks of developing conduct disorder. These findings show that the prevalence of conduct disorder was high among juvenile delinquents and that the occurrence of the disorder was associated with distressful events experienced. This calls for interventions aimed at training parents on effective parenting skills, providing a safe home environment and appropriate treatment for juveniles with conduct disorder.

BackgroundThis article presents key findings of two major empirical studies of psychotherapist and counsellor development. Both aimed to advance knowledge of variations in professional development and better understand the complexity of formative influences.MethodologyThe Minnesota Study of Therapist and Counsellor Development and the International Study of Development of Psychotherapists (ISDP) combined qualitative and quantitative research.ResultsIn the “Minnesota study,” qualitative analysis of data from 100 psychotherapists (172 interviews) at different experience levels led to formulating five phases of practitioner development: the Novice Student Phase, Experienced Student Phase, Novice Professional Phase, Experienced Professional Phase and Senior Professional Phase. Results were integrated in a model describing three developmental trajectories—Continued development, Exhaustion and Disengagement—suggesting a developmentally sensitive approach to supervision. In the ISDP study,...

The main objective of this study was to examine the relations among psychotherapists' epistemic orientation (i.e., intuitive, empiricist, and rationalist), personal style and emotion regulation strategies. Participants in the study were 674 psychotherapists of different theoretical approaches, who completed an online questionnaire containing measures of epistemic orientation, personal style, and emotion regulation strategies. Psychotherapists profiled as predominantly intuitive tended towards broader attention and greater emotional closeness as compared to those profiled as predominantly rationalist or empiricist. Furthermore, they also reported using more strategies for increasing the effects of positive emotions than rationalists. Implications for training, practice and therapist well-being are discussed.

This study explored the phenomenon of parallel process as experienced by a group of four Gestalt and integrative counsellors and psychotherapists and four supervisors. It considered their direct experience of the phenomenon, their understanding and the meaning they ascribe to it, their ways of working with parallel process and consideration of any possible function.

Abnormal Psychology is a rapidly advancing and constantly evolving medical field wherein the things we know about any one disorder will always be quite likely to change or to become better understood over the course of the many studies held each year. With that growth in understanding comes the requirement that those who practice in the field be prepared to change how they approach disorders that were not well understood in the past, but are now.One method used in this field is the utilization of the Diagnostic and Statistical Manual of Mental Disorders-or the DSM. Once there has been enough growth in the field to render the current edition invalid, the book is revised and changed to fit modern understandings. The most recent full revision is between DSM 4 and DSM 5, to which several changes were made. According to the NIH Substance Abuse and Mental Health Services Administration, (Substance Abuse and Mental Health Services Administration (US), 2016) the most notable changes between the two editions of the DSM are as follows. First, the new edition takes a stronger view of the importance of age and lived experience on the mental state of the patient and on the mental development of the patient as factors in determining diagnostic values. This contrasts the DSM 4, which functioned more coldly in terms of considerations for age and development. The largest change, however, was the removal of the Multi-Axial System and the Global Assessment of Functioning (GAF) Score. The Multi-Axial System used multiple axes of factors

There has been a sizable growth in the proportion of multicultural populations in the United States from 1980-1999, and an even larger proportion of culturally different populations is projected for the year 2009. Persons with disabilities, in particular, from Hispanic and Asian cultures represent a substantial proportion of the disabled population in the United States. Recent legislation mandates practices relevant to the rehabilitation, independent living, and employment needs of persons with disabilities in multicultural communities. Cultural variables affecting these populations, such as values and believes, rehabilitation expectations, and attitudes towards disabilities, are examined in this article. Language, acculturation and assimilation are also viewed as important contributors during the rehabilitation process of bicultural clients. The need for rehabilitation professionals to become more competent regarding multicultural issues, as mandated by new regulations, is emphasized.

Zusammenfassung Hintergrund und Fragestellung Die Psychotherapiestrukturreform im Jahr 2017 verfolgte u. a. das Ziel, die Wartezeiten auf Psychotherapien zu verringern. Diese Studie ging der Frage nach, ob dieses Ziel erreicht wurde. Methoden Psychotherapiepraxen aus 7 Bundesländern entnahmen ihren Akten die Daten für Erstkontakt, Erstgespräch und Behandlungsbeginn. Der Vergleich der Wartezeiten auf ein Erstgespräch und auf den Beginn der Behandlung vor vs. nach der Reform erfolgte mithilfe von Kaplan-Meier-Kurven und stratifizierten Log-Rank-Tests. Ergebnis Akten von 1548 Patienten aus 9 Praxen wurden ausgewertet. Die durchschnittliche Wartezeit auf ein Erstgespräch lag sowohl vor als auch nach der Reform bei 3 Wochen (p = 0,20). Die Zeit zwischen der Anmeldung und dem Behandlungsbeginn erhöhte sich von durchschnittlich 18 auf 20 Wochen, wobei nach der Reform v. a. die sehr kurzen Wartezeiten (<10 Wochen) abnahmen (p = 0,0004). Diskussion Die in den Praxen dokumentierten Daten l...

Die Rubrik Psychotherapie und Forschung greift Themen aus der Psychotherapie-Forschung im engeren Sinn wie auch aus anderen Forschungsbereichen auf und kommentiert und diskutiert sie vor allem unter dem Gesichtspunkt der Angemessenheit und Praxisrelevanz der behandelten Forschungsarbeiten für das spezielle Gebiet der Psychotherapie.

The focus of the current study was to examine student-identified academic and mental health concerns, the prevalence of psychological distress in the student population, student utilization of counselling services, and perceived barriers to accessing counselling services. A convenience sample of students ( N = 400) from a large university in western Canada completed a four-page questionnaire that included The General Population – Clinical Outcomes in Routine Evaluation (CORE-GP) and researcher-generated questions. Survey results indicated that 63.1% of students identified having academic concerns, 36.1% of students identified anxiety as a concern, and 31.9% endorsed depressive symptomology as a mental health concern. The criteria for clinical psychological distress were met by 42% of males and 43% of females, yet only a small portion of students identified accessing counselling services for these concerns. Students reported numerous barriers that impeded access to counselling servic...

A working alliance (WA) is a multidimensional construct signifying a collaborative relationship between a client and a therapist. Systematic reviews of therapies to treat depression and anxiety, almost exclusively in adults, show WA is essential across psychotherapies. However, there are critical gaps in our understanding of the importance of WA in low-intensity therapies for young people with depression and anxiety. Here, we describe an initiative to explore the effect of WA on anxiety and depression outcomes in youth aged 14–24 years through a scoping review and stakeholders’ consultations (N = 32). We analysed 27 studies; most were done in high-income countries and evaluated one-on-one in-person therapies (18/27). The review shows that optimal WA is associated with improvements in: relationships, self-esteem, positive coping strategies, optimism, treatment adherence, and emotional regulation. Young people with lived experience expressed that: a favourable therapy environment, reg...

Using case vignettes that differed in the presentation of the client's social class, the influence of social class on therapeutic impressions was studied in the context of just-world beliefs. Results suggested that (1) participants with higher levels of belief in a just world saw poor and working-class clients as more unpleasant to work with and more dysfunctional and (2) working-class vignettes were associated with the lowest predictions of session depth and smoothness. The findings suggest that counselors may respond differently to clients based on their social class, and in a way that negatively predisposes them toward work with poor and working-class clients.

Data for non-urgent undergraduate clients at a University Counseling Center (UCC) were collected using on-line surveys over three time-periods. Despite the expected diminishing number of participants over time, within-time correlations generally showed that level of mental distress and mental health concerns were negatively related to life satisfaction, while self-esteem was positively related. Using a smaller sample of matched-over-three time-periods clients, levels of mental distress and mental health concerns significantly declined, while life satisfaction significantly increased. The strongest changes for this complete data sample were found from Time 1 to Time 3 for reduced mental health concerns and increased life satisfaction. These findings reinforce that additional counseling sessions for undergraduates may be beneficial, and that spreading these sessions out may also be useful. Scientifically demonstrating to higher-level University administration that a UCC can help under...

An empirical summary of 33 studies considers the relationship between racial group orientation and self-concept of an individual. This issue represents a fundamental assumption of afrocentric education practices, that the racial group orientation of the individual is related to the self-esteem of the individual. The results demonstrate a positive relationship between the degree to which a person has a positive orientation towards his or her own racial group and the person's level of self-esteem. Communication scholars increasingly need to consider the issues of interethnic communication-so much of communication scholarship deals with the issues of how a person relates to another as an individual. The development of additional insights and more refined analysis in this investigation will improve the understanding of how persons identify themselves as members of some particular cultural group. (Contains 39 references and 2 tables of data). (Author/CR)

This study explored the counselling self-efficacy of students in a counsellor education programme, in regard to age, gender, and ethnicity characteristics. To assess counselling self-efficacy, the Counselling Self-Estimate Inventory (COSE) of Larson et al. (Counsellor Education & Supervision 41: 120-130, 1992) was administered at the end of a semester to counselling students engaged in different stages of a counsellor training program. No significant differences were found in regard to gender and age-group categories, but significant differences were found among ethnic groups. It was found that Asian and White students generally had similar and also lower counselling self-efficacy means than the other ethnic groups in the sample in regard to several counselling-specific categories. Implications for counsellor educators in training counselling students of diverse characteristics are discussed.

University-associated training facilities for Marriage and Family Therapy/Marriage, Family, and Child Counseling (MFT/MFCC) programs serve several purposes; however, of paramount importance is meeting the academic needs of counselor trainees. Student learning outcomes for counselor trainees aim to address social justice issues, such as primary language and financial impoverishment of clients. This article presents a pilot study that examined an innovative methodology for assessing student learning outcomes at an MFT/MFCC program's training clinic.

Due to changes in traditional social set up, individuals have been estranged from their kin and community that provided the necessary support system, thus an increase in the number of individuals, both males and females looking for professional therapy. University students who mainly comprise of young adults encounter emotional and psychological issues that require therapy. The objective of this study was to look into the gender preference of students seeking therapeutic help. The study is guided by Person Centred and Social Learning Theories. The study applied descriptive survey research design using quantitative and qualitative data. Simple stratified, random and purposive sampling techniques were used to sample three universities, 310 students and seven student counsellors. Data was gathered using in-depth interview schedules, questionnaires and Focus Group Discussions. Quantitative data was examined using descriptive statistics and then presented in Tables, Pie charts and Bar gr...

Introduction: Alcoholic beverages have been a part of social life since ages in the western countries. While alcohol abuse is a problem universally it has not left India untouched. Not only men but also women have included alcohol as a part of their social habit. Aims and objectives: This study aims to find out the prevalence of alcohol use among women residing in rural field practice area of Rajendra Institute of Medical Sciences, Ranchi and to find out the factors leading to initiation and consumption of alcohol. Methodology: This was a cross sectional study done in rural field practice area, ormanjhi of RIMS, Ranchi for a duration of 28 months (from September 2016 to November 2018). The sample size came out to be 336. Templates for data entry were generated in Microsoft office Excel sheet and analysis was done using SPSS 20.0. Results: After analysis of 336 females, it was found that 188 out of 336 (55.95%) of the study subjects are above the age of 40 years, approximately half o...

Im Frühjahr 2020 verbreitete sich das Coronavirus, weshalb die österreichische Bundesregierung einen sogenannten Lockdown verhängte, was Umstellungen an der Ambulanz der Sigmund Freud PrivatUniversität (SFU) in Wien erforderte. Psychotherapeut*innen wechselten das Setting und führten die Behandlungen in Form einer Onlinebzw. Telepsychotherapie fort. Ein Forschungsteam fragte nach den Auswirkungen des Lockdown bedingten Settingwechsels hin zur Fernbehandlung und nach Ende des Lockdowns wieder auf das traditionelle Setting zurück auf die Behandelnden und die Klient*innen der SFU-Ambulanz. Zur Beantwortung der Frage wurden Online-Befragungen mit Klient*innen und Psychotherapeut*innen der SFU-Ambulanz durchführte und mittels zusammenfassender Inhaltsanalyse ausgewertet. Die Flexibilität des Ortes und die Distanz wurden durchaus positiv beschrieben, andererseits führte gerade letztere bei Klient*innen zu verstärkten Gefühlen der Einsamkeit und Isolierung, zusätzlich konnten sich Patient*...

Zusammenfassung Hintergrund Die sprachlichen Äußerungen sind ein zentrales Medium in Psychotherapien, d. h., Psychotherapie wirkt im Wesentlichen über die Sprache, über das Miteinanderreden. Angesichts der Bedeutung des sprachlichen Austauschs ist es relevant, die Mechanismen, über die Sprache in Psychotherapieprozessen wirkt, genauer zu verstehen. Die linguistische Psychotherapieforschung nutzt hierfür vielfältige Methoden. Ziel der Arbeit Vorliegender Beitrag demonstriert exemplarisch 2 mikroanalytische Ansätze. Material und Methoden Eine transkribierte Psychotherapiesitzungssequenz wurde aus Perspektive der psychodynamischen Theorie inhaltlich interpretiert und bezüglich sprachlicher Merkmale mithilfe von 2 Methoden mikroanalytisch beurteilt: Die verbalen Techniken (Fokus Therapeutenäußerungen) wurden mithilfe der Psychodynamischen Interventionsliste (PIL) geratet und eine detaillierte Konversationsanalyse (Fokus Dialog) erfolgte. Ergebnisse Analysen mit der PIL zeigten, dass im ...

Vicarious trauma and burnout are not uncommon among therapists working with individuals who have sexually abused, which highlights the importance of workplace support. The current study aimed to explore sexual offending treatment providers' experiences of workplace support, including support from supervisors and managers, using a mixedmethods approach. Participants (N = 189) completed an anonymous online survey. While quantitative data suggested that participants felt generally supported in their work, qualitative data highlighted nuances in participants' experiences. Support typically came from participants' colleagues and/or supervisors, although supervisory support was sometimes inadequate. Support from senior management was often lacking. Participants described their best supervisors as genuine, warm, empathic, promoting professional growth, knowledgeable and collaborative. Participants' best employers were described in similar ways, in addition to providing good contractual arrangements and effective management systems. Implications for strengthening workplace support that may buffer challenges faced by clinicians, prevent adversarial outcomes and foster therapist longevity are discussed.

Group supervision is a commonly employed method in graduate psychology training. The present study examines the role of group processes in the formation of professional identity among 129 Israeli graduate students following the conclusion of their supervision process. The following three identity statuses were identified: achievement, diffusion, and moratorium. Working alliance and group engagement were significantly higher for achievement students and differentiated between achievement and moratorium students. Cohesion was significantly lower for moratorium students than for students at each of the other two identity statuses. All differences were maintained when controlling for anxiety. Finally, working alliance was found to be the dominant process in predicting committed Keren Hanetz Gamliel, Ph.D., is a lecturer and head of the clinical child track in the graduate program in clinical psychology, School of Behavioral Sciences at The Academic College of Tel Aviv-Yaffo, Israel. She is a supervising clinical psychologist and works in a private clinic. Shulamit

Counselling practicum is a vital component of counseling programs, as it provides counseling students with an opportunity to gain hands-on experience working with clients under the supervision of a licensed or experienced counselor. Therefore, this study sought to explore challenges and prospects of counseling practicum among students pursuing postgraduate degree programs in University of Education, Winneba (UEW) in the Central Region of Ghana. Exploratory case study design within qualitative research approach was adopted in this study. Seven (7) students were sampled using purposive (maximum variation) sampling technique. Semi-structured interviews were used to collect data from the participants. Data were analyzed in themes. It was established that limited availability of practicum sites, inadequate supervision, limited exposure to diverse populations, time management, difficulty in balancing academic coursework and practicum, inadequate resources and limited practical experience were some of the challenges faced by students. Also, to develop counseling skills, gain hands-on experience, network with professionals, and contribution to the field through research and professional development activities were key opportunities for these students. It was concluded that counseling practicum can be a challenging experience for university students, as it requires them to navigate complex ethical, personal, and professional issues into practice, it also contributes to the enrichment of the students' counselling practices and experiences.Recommendations were made based on the findings and conclusion drawn.

Background: Ethical issues are ubiquitous during therapeutic work, despite the presence of professional ethics codes that guide ethical decision making. This exploratory research looks at how mental health trainees and practitioners, across various mental health disciplines, perceive and experience ethical dilemmas in the therapy space. Method: The sample included 12 mental health practitioners from varied mental health disciplines (clinical psychology, psychiatry and psychiatric social work), and practising counsellors, from an urban city in India. Three focus group discussions were conducted, where participants expressed the ethical issues and challenges encountered during their sessions with clients. Results: Content analysis of the narratives of the focus group discussions highlighted prominent ethical dilemmas in these domains: negotiation of boundaries or frames of the interaction; involvement of family in therapeutic decisions; negotiation of issues of gender and power in therapy; value conflicts in working with sexuality issues; therapist competence; and method of resolution of ethical dilemmas. Personal and cultural values emerged as impacting the perceptions, interpretations and experience of ethically challenging situations. The findings have implications for the development of culturally sensitive and value-based training methodologies.

Research on assessing supervisees' professional development (PD) has been primarily focused on either exploring subjective experiences or refining objective aspects of professional competence. As a complement, this study takes a situated /dialogical approach to explore how PD assessments are transacted and conversationally accomplished in actual supervision practice (i.e., how supervisory dyads bring about shared understandings vis-à-vis the supervisee's PD through supervisory talk). Informed by Practice Theory and Ethnomethodology, I explore episodes of supervisory talk that four supervisory dyads regarded as significant to the supervisees' PD (i.e., significant episodes). My focal discursive analysis of six significant episodes examines how participant supervisory dyads express, recognize, account for, negotiate and eventually agree upon relevant aspects of supervisees' PD. I describe five "big" Practices/Outcomes, and three clusters of "small" conversational practices, through which participants negotiated their understandings of supervisees' PD. I further suggest that PD assessments are ubiquitous, negotiated, and reflexive in the supervisory process. Finally, I discuss implications for supervision theory, research, and practice. iii Acknowledgements I wish to gratefully acknowledge the many people who have contributed to this work and supported me along the way:  My wife Inés for being my safe haven, and the super hero who rescued me from madness and boredom. What I wrote here would not be the same without her unending support, help, understanding, and patience.  Camila, for giving me hope, and teaching me there was light at the end of the tunnel.  My supervisor Tom Strong who guided me from day one, whom I admire simply for his devotion to his mentoring activities, always open to give the extra mile to a supervisee who has English as an additional language. He knew how to push me in those times when I thought I had nothing else to give. I owe to him this dissertation big time.  The committee members and mentors who generously shared their time, support, and good counsel: Drs. Jon K. Amundson, Jerry Gale, and Richard Heyman.  My parents for their unconditional love, support and interest in something so far from their interest. My brothers Alfredo and Cristián, for all the exciting philosophical discussions informing this dissertation. My sister Josefina, for reminding me there's life outside of academic writing.  My friends and colleagues who proofread my work more times than I can count, provided me with reassurance while telling me what others would not. In particular, my colleagues from the discourse-interest group.  Karl Tomm and all the wonderful staff and students at the Calgary Family Therapy Centre, who supported and contributed to my research for almost three years. In particular, to the seven participants, supervisors and supervisees, who generously and courageously opened the door for this work to be possible.  Jorge Sanhueza, for his trust, his engagement, and his admirable spirit.  John Shotter, for his wisdom and advice, and for introducing me to Tom Strong.  Dora Fried Schnitman, for her encouragement.  Dr. David Jardine for his inspiring lectures.  Dr. Roberto Arístegui, Dr. Jeff Chang, and Dr. Shari Couture for inspiring me with their work as clinical supervisors. I am also incredibly thankful for the financial support provided by the Government of Chile, through the Becas Chile para estudios de postgrados en el extranjero, and the financial support provided by the Universidad Adolfo Ibáñez.

The purpose of this study was to establish the severity of suicide behaviors and co-existing mental disorders at Federal Neuropsychiatric Hospital, Kappa-Lagos, Nigeria. The sample size of 115 participants was selected at 80% power and 30% effective size using purposive sampling technique. The research used Suicide Behavior Questionnaire (SBQ-R), Beck's Depression Inventory (BDI), and Mood Disorders Questionnaire (MDQ) to collect data. Data obtained from researcher-generated socioeconomic demographic questionnaire and standardized psychological assessment tools was analysed using Statistical Package for the Social Sciences (SPSS) version 23 and summarized in percentages. The results of the study show that suicide behaviors were more predominantly severe among participants aged 18-21 than participants aged 14-17. The prevalence of suicide behavior was noticed among female, university students, and Christians, especially the Pentecostals. In addition, the severity of suicidal behaviors was high among adolescents whose fathers were employed, whose mothers were jobless, whose family economic status was poor and slightly higher among adolescents whose parents lived together compared to those whose parents lived apart.

Unter den Mitarbeitern der Jugendund Drogen-beratungsstelle Drop-in Zürich und der Methadonberatungsstelle des sozialpsychiatrischen Dienstes der psychiatrischen Universitätsklinik Zürich hat sich in den vergangenen 10 Jahren eine grosse Erfahrung mit Behandlungen von delinquenten Süchtigen angesammelt. Die Befragung erstreckte sich über 8 Therapeuten in den betreffenden Institutionen. Alle hatten eine psychoanalytische Arbeitsweise und Ausbildung. Die Arbeit stellt einen Versuch dar, deren umfassendes Wissen über die psychoanalytisch orientierte Behandlung von Süchtigen, Delinquenten und andern gesellschaftlich randständigen jungen Leuten auf quantitative und qualitative Weise zu erfassen und darzustellen. Ein zweites Ziel bestand in der Erprobung einer Kombination von empirischstatistischen mit hermeneutischen Methoden. Theoretischer Hintergrund der Befragung bildete eine moderne psychoanalytische Konzeptualisierung des dissozialen Syndroms und seiner Behandlung auf der Basis der ...

Psychische Störungen überschreiten alle Grenzen – es gibt sie in allen Kulturen, zu allen Zeiten, in allen soziodemografischen Schichten und in jedem Lebensalter. Sie sind häufige Themen sowohl in Talkshows, Fernsehserien und Illustrierten als auch in Literatur, Theater und bildender Kunst. Jeden können sie treffen, und beinahe jeder kennt zumindest eine Person, die an einer klinisch bedeutsamen psychischen Störung leidet. Zu deren Behandlung und Erforschung sowie zur Ausbildung von Psychologischen Psychotherapeuten wurde 1999 am Fachbereich Psychologie und Sportwissenschaften der Universität Frankfurt die Verhaltenstherapie-Ambulanz eingerichtet. Primäres Ziel der universitären Ambulanz ist dabei, die Forschung und Lehre des Fachs »Klinische Psychologie und Psychotherapie « mit der praktischen therapeutischen Arbeit an Klienten zusammenzuführen, um damit die Verbindung aus Forschung, Lehre, Ausbildung und Praxis herzustellen

Background: A working alliance (WA) is a multidimensional construct signifying a collaborative relationship between a client and therapist. Systematic reviews of therapies to treat depression and anxiety, almost exclusively in adults, demonstrate that WA is essential across psychotherapies. A functional WA predicts greater uptake of interventions, client engagement, adherence to treatment, and symptoms reduction. Conversely, ruptured and/or low WA reduces the effectiveness of known-e cacious treatments. However, there are critical gaps in our understanding of the importance of WA in low-intensity therapies for young people with depression and anxiety. We sought to understand the following research questions in young persons aged 14-24 years: 1) the role of working alliance in the ongoing management of anxiety and depression? 2) how do the different working alliance elements in uence treatment outcomes? 3) the client/therapist characteristics deemed essential in forming and maintaining a working alliance? Methods: We conducted a scoping review to summarise and synthesise the ndings collaboratively with young people with lived experiences of anxiety/depression. Then, we conducted key stakeholders' consultations with clinicians [lay health counsellors (n=6), clinical psychologists (n=2), occupational therapists (n=2), and psychiatrists (n=2)], and young people with lived experiences (n=20). Finally, we convened workshops to triangulate/synthesise ndings from the scoping review and stakeholder consultations to develop the mechanistic framework, hypothesising pathways by which WA may in uence treatment outcomes. Results: We analysed 27 studies; most were done in high-income countries. Cognitive behavioural therapy was the most common treatment modality (16/27). Most therapy sessions were conducted one-to-one (18/27), with only two (2/27) studies utilising digital therapy platforms. A functional working alliance was recognised as an active ingredient in psychotherapies targeting anxiety and depression in young persons aged 14-24 years. Previous research has theorised that improvements in the working alliance are associated with improvements in relationships, self-esteem, positive coping strategies, optimism, adherence to treatments, and emotional regulation. During the stakeholders' consultations, young people with lived experience expressed that; a favourable therapy environment, regular meetings, collaborative goal setting and con dentiality were vital in forming and maintaining a functional WA. For a clinician, ssetting boundaries, maintaining con dentiality, excellent communication skills, and being non-judgmental and empathic were considered important for facilitating a functional WA. Conclusions: Although more research is needed to understand WA's in uence in managing anxiety and depression in young people, we recommend routine evaluation of WA. Furthermore, there is an urgent need to identify strategies that promote WA in psychotherapies to optimise the treatment of anxiety and depression in young people. 1. Does better WA improve clinical outcomes of interventions for YP (14-24 years) with anxiety and depression? 2a. What different WA elements (bond, goal, and task) in uence treatment outcomes? 2b. what elements are considered most important by YP with depression and anxiety and therapists? 3a. What therapist and YP patient characteristics (e.g., age, gender) in uence the therapeutic alliance-outcome relationship? 4. Does culture in uence WA and WA-outcome relationships? Methodology First, we conducted a scoping review to summarise and synthesise the ndings collaboratively with YP. After that, we conducted key stakeholders' consultations with clinicians [lay health counsellors (n = 6), psychologists (n = 2), occupational therapists (n = 2), and psychiatrists (n = 2)], and YP with lived experiences (n = 20). After that, we convened a workshop to triangulate/synthesise ndings from the scoping review and stakeholder consultations. The output of the rst workshop was the rst iteration of the mechanistic framework hypothesising pathways by which WA in uences treatment outcomes. After that, YAP representatives independently consulted with the community advisory group (CAG), constituting YP with lived experiences, the appropriateness of the hypothesised model. Finally, we convened a second workshop to nalise the insight analysis collaboratively with YP.

Zusammenfassung Mit der 2023 in Kraft tretenden Reform des Betreuungsrechts wird der Begriff "Wohl" aus dem Gesetz gestrichen. Hierdurch soll stärker hervorgehoben werden, dass sich der Betreuer an den subjektiven Wünschen des Betreuten statt an einem objektiven Wohlverständnis orientieren soll. In diesem Beitrag wird ermittelt, welches Verständnis von Wohl das reformierte Betreuungsrecht in Abgleich zu gängigen medizinethisch-philosophischen Auffassungen des Wohls implizit enthält. Indem untersucht wird, in welchem Verhältnis das betreuungsrechtliche und das medizinethische bzw. philosophische Verständnis von Wohl zueinanderstehen, soll die interdisziplinäre Verständigung zwischen Recht und Ethik gefördert werden. In der Begründung zur Reform wird betont, dass dem Betreuungsrecht weiterhin ein subjektives Verständnis von Wohl zugrunde liege. Dieses Verständnis deckt sich jedoch nicht mit philosophischen subjektiven Theorien des Wohlergehens, nach denen nur das zum Wohl einer Person beiträgt, was diese sich wünscht. Das Betreuungsrecht nimmt hingegen an, dass die Befolgung bestimmter Wünsche zu objektiven Schädigungen der Person führen und damit ihr Wohl beeinträchtigen kann. Negative Konsequenzen für das objektive Wohl eines Betreuten sind betreuungsrechtlich insofern relevant, als dass sie eine Grenze für die Befolgung aktueller Wünsche aufzeigen, die auf einem natürlichen Willen basieren und nicht Ausdruck Dr. med. Esther Braun, M.A.

Surveys indicate that between 6% and 10% of psychiatrists report sexual contact with patients. Surveys also indicate that only a small minority of psychiatrists feel that they have received adequate teaching about this unethical behavior. Educational efforts aimed at reducing sexual exploitation of patients would be of value to trainees, patients, academic programs, and the profession. The authors report their experience with a pilot 6-session course for residents, and a longer model course is outlined. Such education should be mandatory in U.S. residencies. Mandated instruction would be consistent with both the high priority training directors have reported placing on the subject of sexual misconduct in ethics teaching, and with the widespread calls for increased education on this important subject.

A large body of research indicates that therapists can have a strong impact on treatment outcome, but little is known about the relationship between therapist effects and treatment phase. our objective was to examine the interactive effect of therapist effectiveness and treatment phase on the outcome of one year of dynamic therapy. Therapists' effectiveness scores were defined as the extent of change for each therapist on the OQ-45 scores across their clients at five time points. The sample included 24 therapists who conducted psychodynamic therapy with 65 clients in a naturalistic setting. A three-level hierarchical linear model was applied. In accordance with the hypotheses, a significant main effect was found for effectiveness (estimate = 1.69, p < 0.05), for the two-way interactions between effectiveness and time (estimate = 1.36, p < 0.01), and effectiveness and initial severity of symptoms (estimate =-0.02, p < 0.05). Simple slope analysis was conducted showing that among the less effective therapists, no significant change in outcome was found as time progressed; among the more effective therapists, outcome improved as time progressed. In addition, therapists were more influential in the treatments of clients with low initial severity. Our findings lend some support to the notion that therapist effects become increasingly influential as therapy progresses. The findings highlight the need for further research into changes in the magnitude of therapists' effect in various phases of therapy. Furthermore, the severity level of the initial symptoms of the client should be taken into account.

vor dem Anfang-Wie die Therapie in Gang kommt-14 3.2 Grundsätzliches zu Indikationsstellung und Behandlungsplanung-15 3.3 Indikationsstellung für die Einbeziehung von Imaginationen in den psychodynamischen Therapieprozess-ihre drei therapeutischen Funktionen-17 3.4 Grundsätzliches zu Behandlungsvereinbarungen in psychodynamischen Therapien-21 3.5 Imaginationsankündigungen als Teil der Behandlungsvereinbarungen-22 3.6 Besonderheiten der Initialimagination und Hinweise zum praktischen Umgang-24 3.7 Nachbesprechung der Initialimagination-31

Background Adolescence and young adulthood is a risk period for the emergence of mental disorders. There is strong evidence that psychotherapeutic interventions are effective for most mental disorders. However, very little is known about which of the different psychotherapeutic treatment modalities are effective for whom. This large systematic review aims to address this critical gap within the literature on non-specific predictors and moderators of the outcomes of psychotherapeutic interventions among adolescents and young adults with mental disorders. Methods The protocol is being reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) Statement. PubMed and PsycINFO databases will be searched for randomized controlled and quasi-experimental/naturalistic clinical trials. Risk of bias of all included studies will be assessed by the Mixed Methods Appraisal Tool. The quality of predictor and moderator variables will be als...

I would like to thank the following people for their support in completing this thesis. First of all, I want to thank my primary supervisor, Dr Lois Tonkin, who supported me throughout the whole process. I am grateful for her professional encouragement and especially for her belief in me as a qualitative researcher. I also want to thank my second supervisor, Dr Shanee Barraclough, for sharing her remarkable knowledge and kind flexibility supporting my journey to finish this thesis. A special acknowledgement is due to the participants who willingly took part in this research, giving me their valuable time. Thanks for believing in this project and showing genuine interest in my research. I am incredibly appreciative of your trust in me and your honesty and openness, which gave me fantastic material to work with. An expression of thanks to David Roys who kindly helped me by proofreading early drafts and remarkably found the time in a busy schedule. I especially want to thank Philippa Drayton for highly valuable support editing my final drafts. This thesis could not have been written without my husband, Mogens. I am grateful for his never fading faith in me and my ability to finish this research. Thank you for your outstanding patience, loyalty, and support.