The "me too" decision: An analog study of therapist self-disclosure of psychological problems.

OBJECTIVES: To test the exploratory hypothesis that client perceptions of therapists are most favorable when therapists self-disclose their own personal experience with the same psychological problem to a moderate (vs. none, mild, or extreme) extent. METHOD: Undergraduate participants (N = 104; 63.5% female) were randomly assigned to read one of the four vignettes, which differed only in the extent to which the therapist disclosed their own personal experience with the same presenting problem (none, mild, moderate, or extreme). Participants then responded to questions assessing their perceptions of the therapist. RESULTS: The data generally supported the hypothesis. The moderate disclosure condition yielded the most favorable client perceptions, which differed significantly from those yielded by the no disclosure condition. CONCLUSIONS: Despite limitations and need for replication, this study provides perhaps the first empirical data regarding the effect of the extent, rather than the mere presence or absence, of therapist self-disclosure regarding personal psychological experiences.

Doctoral training in clinical psychology across 23 years: Continuity and change.

OBJECTIVE: Doctoral training in clinical psychology has undergone substantial changes in recent decades, especially with the increasing heterogeneity of training models and graduate students. To document these changes, we analyzed program, student, and faculty characteristics of American Psychological Association (APA)-accredited clinical psychology programs over a 23-year span. METHOD: We surveyed directors of clinical training about their doctoral programs every 2 years from 1991 to 2013, securing 90%-98% response rates. With minimal exceptions, the survey questions remained constant. RESULTS: Percentages of female and racial/ethnic minority students continued to grow, such that women now comprise about three quarters of trainees and ethnic minorities about one quarter. There has been a decisive shift in faculty theoretical orientation toward cognitive/cognitive-behavioral and away from psychodynamic/psychoanalytic. Internship match rates were relatively high and stable until the early 2010s but have recently rebounded. CONCLUSION: We discuss the limitations of these survey results and their implications for the future of doctoral training in clinical psychology.

Is depression the past tense of anxiety? An empirical study of the temporal distinction.

It has long been recognised that depression and anxiety share a common core of negative affect, but research on similarities and differences between these two emotions is growing. The focus of the current study was on whether the timing of a triggering event can determine whether the dominant emotional reaction is depression or anxiety. It was hypothesised that aversive events in the past would elicit more depression than anxiety, whereas the same aversive events in the future would elicit more anxiety than depression. We created temporally varied versions of vignettes describing aversive events occurring at either time, and asked participants to rate the extent to which the events would elicit feelings of depression or anxiety. Results indicated that adverse past events elicited much higher ratings of anticipated depression and adverse future events elicited much higher ratings of anticipated anxiety. Implications for understanding these two emotions and depressive and anxiety disorders are discussed.

How big is the competent community? And who gets in?

Comments on the original article, "The competent community: Toward a vital reformulation of professional ethics," by W. B. Johnson et al. (see record 2012-04007-001). Johnson et al. offered a welcome and promising glimpse into the future of psychology ethics. The notion that the field of psychology should encourage its members to make a communitarian commitment toward caring for each other as well as those we serve seems indubitable and perhaps even overdue. Assuming that the merits of the "competent community" are recognized, a couple of subsequent questions regarding its implementation should be addressed. First, how big should the competent community be? The second question centers on who gets in to our professional community in the first place: Should admission to graduate programs in psychology depend on an applicant's commitment to communitarianism?

Ethical? Toward whom?

Comments on the original article, "Nonrational processes in ethical decision making" by M. D. Rogerson et al (see record 2011-19198-001). Among the many insightful points made by Rogerson, Gottlieb, Handelsman, Knapp, and Younggren (October 2011) regarding nonrational processes in ethical decision making, one deserves further explication: Many of psychologists' ethical decisions lead to actions done to someone. Unfortunately, frameworks and models of ethical decision making frequently neglect this fact by implying that the decisions happen in the abstract, but in truth, these decisions often affect a specific recipient. Importantly, the characteristics of that specific recipient, especially as perceived by the psychologist, can have a powerful impact on the process of ethical decision making (Caughron et al., 2011). It would be wise to add such a hypothetical to the list of specific questions that Rogerson et al recommended psychologists ask themselves: Would I make the same ethical decision if the person(s) toward whom the decision is directed had different characteristics?

The influence of length of marriage and fidelity status on perception of marital rape.

To what extent does the length of the marriage or the wife's faithfulness to the husband influence the perception of responsibility or trauma in marital rape? In the current study, each participant was presented with one of four marital rape vignettes. The vignettes varied only in the length of the marriage (3 years or 15 years) and the fidelity status of the wife (continuously faithful or involved in an ongoing sexual affair with another man). Results indicate that both length of marriage and fidelity status significantly influence perceptions of marital rape. Specifically, participants assigned greater responsibility for the rape to unfaithful wives than to faithful wives. This finding is particularly salient for wives in long-term marriages as compared to wives in short-term marriages. Additionally, participants perceived rapes within long-term marriages as more traumatic than rapes within short-term marriages.

Increasingly informed consent: discussing distinct aspects of psychotherapy at different points in time.

Psychologists are ethically obligated to obtain informed consent to psychotherapy "as early as is feasible" (American Psychological Association, 2002, p.1072). However, the range of topics to be addressed includes both information that may be immediately and uniformly applicable to most clients via policy or rule, as well as information that is not immediately presentable because it varies widely across clients or emerges over time. In this study, licensed psychologists were surveyed regarding the earliest feasible point at which they could provide information regarding specific aspects of psychotherapy. Results indicate that, although psychologists believe that they are capable of presenting some information, such as payment and confidentiality policies, at the outset, they believe that a discussion of more substantive issues, such as psychotherapy duration, goals, orientation, and activities, can take place only after some therapy has transpired. Implications are discussed regarding the process and event models of informed consent.

How does clients' method of payment influence psychologists' diagnostic decisions?

To what extent does payment method (managed care vs. out of pocket) influence the likelihood that an independent practitioner will assign a Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) diagnosis to a client? When a practitioner does diagnose, how does payment method influence the specific choice of a diagnostic category? Independent practitioners responded to a vignette describing a fictitious client with symptoms of depression or anxiety. In half of the vignettes, the fictitious client intended to pay via managed care; in the other half, the fictitious client intended to pay out of pocket. Payment method had a very significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to receive diagnoses and more likely to receive adjustment disorder diagnoses in particular. We discuss implications involving informed consent and other ethical issues.

Who plays the client? Collaborating with theater departments to enhance clinical psychology role-play training exercises.

This article offers a description of a student-active method of teaching clinical psychology applications, such as interviewing and psychotherapy, that involves collaboration between psychology and theater departments. Clinical psychology instructors recruit theater students to play the client roles in live dyads with the instructors or other students. These dyads may take place during or outside of class and may be videotaped for use in other educational settings. Practical and logistical issues are discussed, and empirical data are presented to demonstrate the effectiveness of this method.