Failures in psychodynamic psychotherapy.

This article addresses the issue of failures in psychodynamic psychotherapy. Drawing on the clinical and research literatures, and utilizing our clinical experiences, we first describe and define criteria for success and failure in treatment. We then review five factors that can lead to failure: client factors, therapist factors, technical factors, relationship factors, and environmental factors. We illustrate our presentation with a case example, and conclude by discussing ways in which the likelihood of failures in psychodynamic treatment can be lowered.

The gap between science and practice: A conversation.

The authors, friends, colleagues, and collaborators for almost 60 years engage in an informal discussion concerning the gap between science and practice. They identify some sources of the problem, some manifestations of it, and point the way to some possible solutions. The articles in this special section, because of their use of data collected in a naturalistic setting and the prominent role of clinicians, are viewed as one of many promising directions for the reconciliation of the activity of researchers and the needs of clinicians. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The process of assimilative psychodynamic integration.

Assimilative psychotherapy integration is described and then characterized by a series of common processes: (1) multiple selves; (2) rupture repair; (3) corrective emotional experience; and (4) homework. These processes each have some degree of research support, are related to each other because of their contribution to the therapeutic relationship, and contribute to evidence-based practice.

The test of time: Strupp and Hadley's tripartite model of mental health (1977).

The original article by Strupp and Hadley (1977) is summarized, and its implications for practice, theory, and research are spelled out. The article anticipates constructivism in theory and practice and makes an important point about the independent value of the perspectives of the patient, the therapist, and society. However, contemporary research shows little incorporation of this valuable work.

The local clinical scientist, evidence-based practice, and personality assessment.

The local clinical scientist model was devised for clinical practitioners including those engaged in personality assessment. It emphasizes the importance of local data, the consideration of each clinical encounter as a mini-research project, and the incorporation of existing research data where relevant. It is consistent with, but goes beyond, evidence-based practice. There is a need to guard against the operation of cognitive heuristics for the model to be applied effectively.

Old wine in new bottles.

The matrix model as described by C.R. Snyder and T.R. Elliott (this issue, pp. 1033-1054) is presented as an alternative to the Boulder model of training. In fact, it appears to be a reconceptualization of clinical psychology, and this newer vision of the field might best be implemented within a Boulder model format. The extensive requirements that are developed would best be approached through changes in postdoctoral rather than doctoral education. Interestingly, professional schools, despite being disparaged, may be the most likely place for this model to take root.

The unification of psychology and psychological organizations.

The Tree of Knowledge is an imaginative attempt to construct a metatheoretical system that proposes to unify the discipline of psychology. However, it is limited in its appreciation of political factors, and so an optimistic view of the possibility of the system overlooks the power issues that beset the field.

The many faces of self-disclosure.

The contributions of eight authors to this issue of In Session are discussed, with emphasis on who discloses what to whom, in what ways, and for what reasons. The primary conclusions concern the varieties of self-disclosure, the motives for self-disclosure, the appropriate outcome variable in studying self-disclosure, the value of evidence, the importance of the context, and the crucial role of the relationship. Self-disclosure, properly used, can be a significant contributor to successful psychotherapy.

What is a scientist-practitioner anyway?

The scientist-practitioner model is the dominant approach to training in clinical psychology, but it is more readily realized in theory than in practice. The articles in this series consider ways to make research more accessible to the practitioner in a realistic and helpful manner, and to allow practitioners to influence the course of research. Many innovative models are described, and they converge on a high value placed on methodological pluralism. Many of the authors, explicitly or implicitly, endorse psychotherapy integration, and also portray a practitioner who bears resemblance to the local clinical scientist.

A consideration of challenges to psychological assessment instruments used in forensic settings: Rorschach as exemplar.

In this brief primer, we provide an outline of key issues that will help psychologists organize and prepare their expert testimony. These issues include the need to obtain essential sources of research, a review of the actual legal standards regarding admissibility of test data in expert testimony, the nature of the expert relative to the assessment instrument in expert testimony, the nature of legal versus scientific debate, and the examination of appropriate qualifications of expertise when offering legal testimony. In addition, we use a summary of information contained in several recent articles to address challenges directed against forensic psychological testing. We use the empirical literature on the Rorschach as an exemplar in discussing these issues, as the admissibility of the Rorschach in particular has been challenged, and the issues frequently focused on with the Rorschach are equally applicable to other psychological measures. In this article, we provide essential sources of Rorschach research regarding several empirical studies that summarize important information and directly address previous criticisms of the measure.

Case vignette: cybertherapy.

Dr. Neuro Transmitter, a psychotherapist in Paramus, New Jersey, provides services through an online, real-time consultation service known as CyberShrink, Inc., of Dallas, Texas. He is paid by the hour for his consultation services to subscribers who are billed by credit card through CyberShrink. One afternoon he logs on and is connected via private "chat channel" to a new subscriber to the service. She is Ann Hedonia of Simi Valley, California. Ten minutes into the session, Dr Transmitter recognizes that Ms. Hedonia is seriously depressed with suicidal ideation and is feeling on the edge of her ability to cope. He gently suggests that perhaps she ought to think about hospitalization near her home. Ms. Hedonia replies, "Even you don't care about me! That's it. I'm going to do it!" and disconnects. Discussion questions: Is offering psychotherapy services online ethical? What are Dr. Transmitter's obligations in general and at this particular moment to Ms. Hedonia? Suppose Ms. Hedonia has a complaint about Dr. Transmitter. From whom can she seek a remedy? Which state's laws apply regarding professional practice, confidentiality, or licensing qualifications? Must Dr. Transmitter be licensed in any state to offer this service?