Dreaming of you: client and therapist dreams about each other during psychodynamic psychotherapy.

OBJECTIVES: Our objectives were to describe the frequency of therapists' dreams about their clients and clients' dreams about their therapists, to determine how therapists and clients who had such dreams differed from those who did not have such dreams, whether therapy process and outcome differed for those who had and did not have such dreams, and to describe the content and consequences of these dreams. METHODS: Thirteen doctoral student therapists conducted psychodynamic psychotherapy with 63 clients in a community clinic. RESULTS: Therapists who had dreams about clients had higher estimated and actual dream recall than did therapists who did not dream about clients. Qualitative analyses indicated that therapists' dreams yielded insights about the therapist, clients, and therapy; therapists used insights in their work with the clients. Among the clients, only two (who were particularly high in attachment anxiety and who feared abandonment from their therapists) reported dreams that were manifestly about their therapists. CONCLUSIONS: Therapists-in-training dreamed more about their clients than their clients dreamed about them. Dreams about clients can be used by therapists to understand themselves, clients, and the dynamics of the therapy relationship.

Exploring the dreams of hospice workers.

Nine adults who worked at least 1 year with patients at US hospice centers completed an in-person audiotaped dream session focusing on a dream about a patient. Data were analyzed using consensual qualitative research. Patients were generally manifestly present in participants' dreams, and dreams were typically realistic (i.e., not bizarre). In the dream, the dreamer typically interacted with the patient as a caretaker but was also typically frustrated by an inability to help as fully as desired. Dreams gave dreamers insight into the stress of hospice work, their own fears of death, and inter-/intrapersonal interactions beyond hospice work. Dreamers generally sought to take better care of themselves and find balance in their lives after the dream session. Implications for research and practice are discussed.

Supervisor self-disclosure: supervisees' experiences and perspectives.

Twelve graduate-level supervisees were interviewed regarding their experiences of supervisor self-disclosure (SRSD); data were analyzed using consensual qualitative research. When describing a specific SRSD experience, supervisees reported a range of antecedents (e.g., difficult clinical situation, self-doubt, tension in supervision relationship) followed by supervisor disclosures about clinical experiences or personal information. Supervisees perceived that their supervisors disclosed primarily to normalize, but also to build rapport and to instruct. The SRSDs had mostly positive effects (e.g., normalization), though some negative effects (e.g., deleterious impact on supervision relationship) were reported. Implications of these findings for supervision, training, and research are addressed.

Therapist training, feedback, and practice for dream work: a pilot study.

Thirteen therapists (8 women, 5 men; M age = 29.1 yr., SD = 6.3; M counseling experience 2.7 yr., SD = 6.3, range = 1 semester to 8 yr.) received training in the cognitive-experiential model of dream work through a didactic-experiential workshop, individual feedback, and practice. All participants but one were enrolled in masters' or doctoral level counseling training programs. An examination of effect sizes indicated that (a) therapists' self-efficacy about using the dream model increased substantially and positive attitudes toward dreams increased slightly after the didactic-experiential workshop; (b) the process and outcome of the second dream session were better for therapists who received individual feedback after the first session than for therapists who did not receive feedback after the first session; and (c) for the subgroup of six therapists who conducted five sessions, therapists' attitudes toward using the dream model improved, and their self-efficacy for working with dreams and perceived self-competence in dream work increased.

Clients' experiences giving gifts to therapists.

Nine therapy clients were interviewed regarding their experiences of giving gifts to therapists. Data were analyzed using consensual qualitative research. In describing a specific event when they gave a gift that was accepted, participants described having a good relationship with the therapist and usually identified their therapy concerns as relationship or family struggles or both. Most bought a relatively inexpensive gift they thought their therapist would like and gave it during a nontermination session to express appreciation or mark an important life event. Most participants acknowledged mixed emotions when giving the gift and noted that any discussion of the gift was brief and did not explore its deeper meaning. Nevertheless, most participants perceived that gift events positively affected them and their therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Case studies of the attainment of insight in dream sessions: replication and extension.

To replicate and extend the Hill, Knox, et al. (2007) case study of a client who attained insight in one session of dream work, the authors examined two additional single-session cases: one in which a client gained insight and another in which a client did not. The observations across all three cases suggest that the two clients who acquired insight had positive attitudes toward dreams; were motivated and involved in session; and were nonresistant, trusting, and affectively present but not overwhelmed. The client who did not gain insight questioned the value of dreams and was resistant, untrusting, and emotionally overwhelmed. Therapist adherence and competence using the dream model, ability to manage countertransference, and effective use of probes for insight distinguished the therapists whose clients gained insight from the therapist whose client did not.

Predoctoral interns' nondisclosure in supervision.

In interviews with 14 counseling center predoctoral interns regarding a significant nondisclosure in supervision, eight interns reported good supervisory relationships and six indicated that they experienced problematic supervisory relationships. Nondisclosures for the interns in good supervisory relationships related to personal reactions to clients, whereas nondisclosures for interns in problematic supervisory relationships related to global dissatisfaction with the supervisory relationship. In both groups, interns mentioned concerns about evaluation and negative feelings as typical reasons for nondisclosure. Additional reasons for nondisclosure for interns in problematic supervision were power dynamics, inhibiting demographic or cultural variables, and the supervisor's theoretical orientation. Both groups described negative effects of nondisclosure on themselves and their relationships with clients. Interns in problematic supervision also reported that nondisclosures had negative effects on the supervisory relationship.