心理治疗与咨询中临床督导工作的探讨

本文对国外临床督导的相关问题进行回顾,针对目前我国心理咨询和心理治疗专业发展要求,心理咨询和心理治疗职业培训中对临床督导工作的大量需求、意义、目标和内容等进行了讨论,并探讨了适合我国临床督导工作的思路.     

婚姻危机的短期心理治疗

随着社会不断发展，人们承受的心理压力也在增强，心理咨询和治疗日益得到重视，心理培训层出不穷，从业人员之间的督导交流不断增强，但目前国内发表的心理咨询和治疗方面文章中多是横段面如一次晤谈介绍，不甚系统，且很少涉及治疗师的内心体验。本文通过介绍对一位女士婚姻危机的短期心理治疗，希望能提供此方面的交流，接受同行督导。     

系统取向理论解析公开联合督导的个案报告

本文以北京大学首次公开联合督导心理咨询的1个案例,尝试建立心理动力学、认知行为学、系统式家庭治疗等多层次的系统取向整合性督导,以促进受督者对个案的理解,为受督者提供整合性视角,协助督导师完成整合性心理治疗教学,启发心理治疗培训的课程设置,进而提升心理治疗的专业性与有效性。     

我国心理咨询与心理治疗的发展状况

<正>我国心理咨询与治疗从业者所采用的折衷方法多于单一方法,多数折衷方法是认知疗法和行为疗法的延伸或整合。但是,他们所采用的方法绝大多数来源于国外,虽然也有极少数本土化和本土的方法,但其研究及推广有限。同时,专业化程度不高,心理咨询的督导状况堪忧。因此,心理咨询与治疗专业还有待进一步地发展和完善。1多种多样的心理咨询与心理治疗的方法和实践     

爱其所是——梅达特·鲍斯的存在分析心理治疗观解析

瑞士著名精神病学家和临床心理学家梅达特·鲍斯成功地整合了海德格尔的存在主义哲学以及弗洛伊德的精神分析学,由此成为了西方心理学重要流派之一——存在分析学的缔造者。在美国存在分析督导师的临床督导下,作者结合本土化的存在分析心理咨询实例,对存在分析学所倡之心理治疗态度、心理治疗目标以及治疗技术三个部分进行了详细解析。勾画出了存在分析学的整体心理治疗观,从理论和实践两个角度体现出了存在分析心理治疗之精髓。     

心理督导师的从业基本状况及其伦理行为

目的:了解心理督导师从业基本状况及其伦理行为的现状.方法:采用问卷调查法,以自编"心理咨询和治疗伦理问题调查问卷(咨询师版)"作为评价工具.按同行推荐线索发放问卷1000份,回收601份有效问卷,其中回答"在为其他心理咨询或心理治疗人员作督导"167人,列为心理督导师组;根据督导组的性别比例在余下的434份问卷中随机分层抽取178人为对照组.结果:(1)心理督导师组的中、高职称比例(72.5%)高于对照组(51.4%);督导师组咨询实践从业年限6年以上者占46.4%,平均每周工作时间6小时以上者67.7%,而对照组分别为20.0%和39.1%;与对照组相比,心理督导师对每一个来访者平均的治疗次数多、遵守咨询时间更好、收费更高(督导师组每例来访者平均治疗次数6次以上、咨询时间在50分钟/次、收费>50元/次,分别为 62%、74.9%和78.5%,而对照组分别为37.1%、57.6%和60%);督导师组接受3个月以上脱产培训或连续2年正规心理治疗培训者(78.2%)多于对照组(54.4%).以上两组间的比较差异均有统计学意义(P<0.01).(2)在心理咨询和治疗的过程中,督导师组较对照组较少有力不从心、难以胜任之感(67.7% vs.79.7%),较少有害怕、担心等负性情绪体验(46.3% vs.67%),更多的人接受过心理治疗或督导(78.8% vs.63.5%),能更好地遵守时间设置(76.5% vs.62.3%),知情同意方面交代得更清楚(87.8% vs.78.2%,Ps<0.05).结论:国内目前心理督导师的从业基本状况较好,较心理咨询和治疗师有较高的资质,行业伦理行为(如专业能力、知情同意、遵守治疗设置方面)多数较好,有些方面(如双重关系、隐私保密方面)尚需加强.     

治疗者与异性来访者之间的关系的讨论

为促进和推动我国心理治疗与心理咨询事业的健康发展 ,我刊于 2 0 0 1年开始应广大读者的要求 ,推出了与心理治疗及心理咨询相关问题的讨论专栏 ,专栏的目的在于讨论和澄清有关心理治疗与心理咨询专业工作中的一些基本问题 ,重点问题和疑难问题 ,以达到“百家争鸣”和普及与提高之目的。今年本专栏将继续对有关问题进行讨论。经一些同行和读者建议 ,本刊在今年的讨论中将集中就心理治疗、咨询人员与其来访者的关系问题进行讨论。可能涉及的题目有 :治疗中督导的意义和作用 ;治疗协议对治疗关系和治疗过程的影响等 ;治疗目标对治疗关系和治疗过程的影响等 ;治疗师个人特征与治疗中的理论取向。希望国内同行对上述问题踊跃投稿 ,发表自己的意见和看法 ;也希望大家将自己认为重要的、值得讨论的问题告诉我们。我们将分期、分批整理和筛选大家的意见予以刊登 ,或在必要时分别邀请不同心理治疗学派的专家、学者发表意见。来信请寄本刊 (10 0 0 83　北京市海淀区花园北路 5 1号　北京大学精神卫生研究所 ,中国心理卫生杂志 )或专栏负责人钱铭怡教授 (10 0 871　北京大学心理学系 )。请在来稿中写明作者的工作单位、职业 ,以及通讯地址、联系电话和电子邮箱地址。     

“多能父亲、无能母子”家庭治疗个案督导

对心理咨询的临床督导是促进家庭治疗师专业能力发展、确保心理咨询服务质量的重要机制。本文描述了家庭治疗中一对一案例报告式督导的主要过程,突出了家庭雕塑技术与"假设-循环-中立"原则在临床督导中的应用,以及家庭治疗的资源取向风格。本案例督导对家庭治疗师的专业能力提升和该家庭系统的变化都起到了积极的作用。     

心理咨询师该拥有怎样的特质？

近些年来，我国的心理咨询与心理治疗事业迅速发展，行业发展的需要已经对心理咨询与治疗工作的质量提出了更高的要求。人们开始关注，除了与心理咨询相关的知识与技能外，能够胜任心理咨询师工作的专业人员必须具备什么样的基本素质和人格特征？     

《中国临床心理学杂志》心理咨询与治疗文章(1993-2007)内容分析

目的:分析<中国临床心理学杂志>从1993年创刊到2007年刊载的心理咨询与治疗领域的文章,作为了解该领域学者们研究视角、关注热点及其发展变化趋势的参考. 方法:对筛选出的心理治疗与咨询204篇相关文章进行内容分析,并对文章的研究者及其所属机构、研究.方法、被试群体均进行统计. 结果:心理治疗与咨询类文章约占该刊所发表文章的十分之一,按内容被划分为七类,疗效研究所占比例最高.实证研究多于非实证研究.被试群体以成人为主,大学生次之.在心理咨询和治疗领域中发表论文最多的机构和个人均为医学背景. 结论:做为核心期刊.<中国临床心理学杂志>15年间所发表的心理咨询与治疗的文章反应了这一领域在中国的发展变化,是心理咨询与治疗研究者与实践者的重要参考刊物.     

Outcomes management,expected treatment response,and severity-adjusted provider profiling in outpatient psychotherapy

To make use of psychotherapy research in practice, therapists need real-time access to valid clinically relevant information about patients. The dose-effect and phase models of psychotherapy provide a theoretical background for empirically based psychotherapy management by describing the systematic nature of progress in therapy and guiding the selection of outcome criteria. Given this theoretical background, it is possible to derive appropriate models for monitoring cases in ongoing therapies (patient profiling) and identifying therapists' relative strengths and weaknesses (severity-adjusted provider profiling). These applied methods may be used to inform decision making in ongoing psychotherapies and to support supervision and clinical training.     

Issues in teaching and learning time-limited psychodynamic psychotherapy.

Psychodynamic psychotherapy training is briefly reviewed, with particular attention to short-term forms of treatment and to empirical investigations of therapy training. There have been relatively few investigations of actual psychotherapy training, and the prospect is for even fewer in the future. The traditional pedagogic strategy for conceptualizing and developing psychodynamic training programs has been to adapt psychoanalytic clinical theory for instructional purposes. It is proposed that concepts, principles, and instructional strategies from the area of the cognitive sciences concerned with the development of generic expertise offers a potentially more fruitful theoretical/empirical framework for understanding therapeutic expertise and can be applied to developing improved psychotherapy teaching methods. The mental processes of therapists are discussed from this perspective. A teaching format based on multimedia computer technology and designed to fill a gap between didactic course work and actual therapy supervision is briefly described. In addition, recommendations are offered for improving psychotherapy training using existing methods.     

The embodied intersubjective space: the role of clinical intuition in somatic psychotherapy

Interpersonal neurobiology has provided insight and given importance to right brain implicit processes within the context of psychotherapy. This includes intersubjectivity, awareness of bodily felt experience, and clinical intuition. The field of somatic psychotherapy utilises the awareness of sensorial experience and embodiment as sources of knowledge through the integration of mind and body in the process of healing. This article explores the relationship between the somatic experiences of intuition and the field of somatic psychotherapy through an epistemological vision of providing insight and ground to a common, yet not fully understood phenomenon in clinical practice. A definition of clinical intuition from a somatic perspective is presented as well as a three-phase non-linear model that incorporates understandings from neuroscience and interpersonal neurobiology. The embodied intersubjective field, hemispheric integration, and embodiment practices are explored in this model to serve as a bridge between theory and practice and to hold the potential for transformation.     

Cure and care of neurosis. I. Cure.

Behavioural psychotherapy has long historical roots. Recently it has led to effective treatment for selected neuroses, including phobic, obsessive-compulsive and sexual disorders. Potent therapy has become a tool of experimental psychopathology which advances theory and practice. A pervasive principle is exposure of the patient to those stimuli which evoke his discomfort until this subsides. Level of arousal during exposure does not affect outcome. Theoretical issues are reviewed which decide when exposure will be sensitizing or habituating. Both psychoanalytical and conditioning models of neurosis are out of date, and models derived more directly from clinical experiment are becoming possible. The aetiology of phobias and rituals can be seen as failed extinction rather than enhanced acquisition. Relevant phylogenetic and biological factors are discussed. At the other extreme, well-documented faith-healing indicates huge gaps in our knowledge of psychotherapy.     

A metamodel of theories of psychotherapy: a guide to their analysis,comparison, integration and use

Every theory of psychotherapy is composed of a myth and an associated ritual. A myth is a conceptual scheme for explaining clinical problems. A ritual is based upon a myth and is a model of the clinical change process. This article goes far beyond the observation that theories of psychotherapy consist of a myth and a ritual to propose that they share a common underlying structure. The central purpose of this article is to delineate this structure. This structure constitutes a metamodel of theories of psychotherapy. The article shows how the metamodel is a fresh conceptual tool (a) for understanding, analysing, comparing and contrasting, and integrating the basic concepts and principles of theories of psychotherapy and (b) for building case formulations and treatment plans from a theory of psychotherapy. Copyright © 2003 John Wiley & Sons, Ltd.     

Telesupervision: Building bridges in a digital era

Technological advances have revolutionized the way we think of counseling and psychotherapy education. Not only are we able to reach trainees, counselors, and clients in the far corners of the world, but Internet-based educational processes have transformed the process by which we deliver curriculum and engage in supervision practices. This study highlights a training model that has been successfully used at one institution for preparing supervisors-in-training to engage in telesupervision. Through empirical data, we highlight lessons learned—challenges, benefits, ethical dilemmas, the impact of telesupervision practices on the supervisory working alliance, and attitudes towards and willingness to use telesupervision in the future. Implications for training and supervision in a global society are addressed.     

Getting our act together: lessons on meaningful psychotherapy research from the philosophy of science

Psychotherapy research should concentrate on building up a scientifically validated, theoretical knowledge base by means of disciplined empirical research. The normal nested relationship between technology, theory, and research has not been the norm in the world of psychotherapy. Psychotherapy researchers should learn from the history of science and concentrate on building basic theory. Investigations into the causal relations underpinning psychotherapy is the best way that research can help us do psychotherapy better. These investigations must conform to the canons of inductive reasoning. Conventional use of clinical data to underwrite psychotherapeutic theory is vulnerable to Grünbaum's critique. A research proposal based on Langs' communicative approach to psychotherapy is presented predicting measurable unconscious responses to brief, time-limited psychotherapy.     

Are Psychotherapists Out of Touch?

ABSTRACT. Touching - as well as not touching - conveys messages- It also constitutes aprimary experience with emotional and trophic effect Both functions arc important for psychotherapy.
Attachment theory logically implies (and experience confirms) that patients who lacked adequate mothering in early life require - like children - actual physical cam-giving. It may he necessary to communicate with some patients by touch before treatment can start, whereas others are at first afraid to be touched. However, an essential pan of psychotherapy is enabling patients to lose their fear of accepting what they need.
Objections m therapeutic touching are subjective and due largely to sexual fears. Problems in this area emphasise the imperative need for all psychotherapists to have regular access to therapeutic supervision.